From Sacramento Bee 7/29/2010 

Studies: Forced breathing not needed in adult CPR

B^y THOMAS H. MAUGH 11 Los Angeles Times

LOS ANGELES - Chest compressions alone are as effective in rescuing victims of heart attacks as conventional cardiopulmonary resuscitation that combines compressions with forced breathing, researchers said Wednesday.

Studies in Washington state and Sweden confirm the growing idea that the breathing component of CPR is necessary only for children and those who have suffered drowning or who have respiratory problems.

Recent guidelines based on these and earlier studies may overcome some of the fears of bystanders who are reluctant to initiate CPR because of the danger of infectious diseases.

"These studies reinforce the message that the American Heart Association has been promoting since 2008," said Dr. Michael Sayre, a professor of emergency medicine at Ohio State University in Columbus and a spokesman for the heart association. "When you encounter a person who has collapsed suddenly, the best thing to do is to call 911 and then push hard and fast on their chest. It's simple, and something anyone can do even if they don't have any training."

Communities that are already using the new approach are seeing dramatic increases in survival of people who experience heart attacks, said Dr. Paul E. Pepe, head of the Emergency Medicine Department of the University of Texas
South Western Medical School in Dallas .

From Greg Scandlen Newsletter #225               6/10/2010
Germany
 
Speaking of one standard for the Feds and another for everybody else, Ron Bachman writes up the results of his trip to Germany where he dug deep into the German system. He writes, "We listened to federal and state officials, doctors, hospital executives, members of the Bundestag, a health journalist, and German policy experts. They told us that the German system is the fourth most expensive system in the world. Their costs are rising rapidly and are unsustainable." He says he pressed these people on what were the three best characteristics of the German system, and they could come up with only two - Solidarity and Progressive Financing. "Quality, access, cost effectiveness, choice, and convenience were never mentioned."
 
He goes on to say that, 90% of the population is in "compulsory statutory social health insurance through 170 plans (where) there are waiting times for office visits, delays for elective hospital care, and postponed care if quarterly medical budgets are exceeded. Choice of physicians/surgeons is limited and private hospital rooms are not available."
 
Ten percent of the population is "covered by 50 private insurance plans. Those with private coverage get to the head of the line for appointments, have access to private hospital rooms, and use of 'master' surgeons and leading specialists for care." Ron writes, "I asked, who are those individuals and how many Germans get the private coverage as complimentary? The response was that federal government employees, state employees, professors, and others are defined as civil servants." They make up 80% of those enrolled in these private plans.
 
Not all pigs are equal on this plantation.
 
SOURCE:
Daily Caller

For more information   www.greg@chcchoices.org

From Greg Scandlen News Letter #231,  7/20/2010

Once More to Massachusetts
 
Writing in the Wall Street Journal on July 7, Joseph Rago looks at how the Bay State is doing as a model for ObamaCare and concludes, "the Massachusetts plan couldn't be a more damning indictment of ObamaCare." He begins with the arbitrary price controls on insurance premiums that ignored the advice of the state's professional insurance regulators, and were eventually reversed by a state appeals board. Still, he says, "the five major state insurers have so far collectively lost $116 million due to the rate cap. Three of them are now under administrative oversight because of concerns about their financial viability."
 
Now, the governor "wants to export the rate review beyond the insurers to hospitals, physician groups and specialty providers-presumably to set medical prices as well as insurance prices," and a state senator "has introduced a new bill that will make physician participation in government health programs a condition of medical licensure."

SOURCE:
Wall Street Journal

 
Robert Samuelson takes a similar view in The Washington Post and decides that the Massachusetts experience is "not encouraging." He says, "The state did the easy part: expanding state-subsidized insurance coverage. It evaded the hard part: controlling costs and ensuring that spending improves people's health."
 
He acknowledges that the state reduced the numbers of uninsured and slightly improved access, "But much didn't change. Emergency rooms remain as crowded as ever (and) state leaders have proved powerless to control costs." He adds that state spending on health care has risen from 16% of its budget in 1990, to 22% in 2000, and 35% this year. Health care is squeezing out everything else the state is expected to do.
 
He says, "A year ago, a state commission urged another approach: Scrap the present "fee-for-service" system," in favor of a "global budget." "But the commission offered no blueprint, and efforts to craft consensus among providers, consumer groups and insurers have failed. State Senate President Therese Murray, an advocate of payment change, has given up for this year. 'Nobody is in agreement on anything,' she told the Boston Globe."
 
He concludes, "What's occurring in Massachusetts is the plausible future: Unchecked health spending shapes government priorities and inflates budget deficits and taxes, with small health gains. And they call this "reform"?
 
SOURCE:
Washington Post

For more information   greg@chcchoices.org

Tags: Donald Berwick, free markets, health care, Obama, Recess Appointment, redistribution of wealth

Washington, DC (LifeNews.com) -- If President Barack Obama thought he would get away with appointing rationing advocate Donald Berwick as the head of Medicare and Medicaid and not see a response from Senate Republicans, he should think again. They have responded aggressively by blocking judges and demanding a hearing.

Berwick is the new director of the Center for Medicare and Medicaid Services who has praised British programs that ration care.

The position is important because it will oversee implementation of the massive government-run health care plan that pro-life advocates say will foster rationing and also contains taxpayer funding of abortions.

Senate Republican lawmakers are upset that Berwick never received a hearing or vote before Obama went around the Senate and used a recess appointment to allow him to head the agency through the end of next year.

In response, Senate Republican Leader Mitch McConnell blocked a request Wednesday from Democrats to approve two Obama nominees to the U.S. Court of Appeals for the Fourth Circuit.

Also, Wednesday evening, Republican members of the Senate Finance Committee demanded a public hearing on Berwick and his controversial rationing views. Full story at LifeNews.com

Health Care Freedom Acts
Spreading Across the United States

"In 2006, physicians Eric Novack, M.D. and Jeff Singer, M.D. (who are also AAPS members) laid the foundation for the Arizona Health Care Freedom Act which will be on the Arizona ballot in November 2010.  It is the prototype for other such acts now being considered across the United States."

"The US Health Freedom Coalition is supporting efforts to enact  Health Care Freedom Acts in all 50 states..." 

"...The Health Care Freedom Act protects 2 rights:

1) The right to choose NOT to participate in any health care system or plan WITHOUT a penalty, fine, or tax. Because it is not what you GET when you join, but it is the FINE PRINT you are now subject to: ALL the rules, regulations and restrictions.

2) The right to spend your own money to get access to any lawful health care service. Because NO BUREAUCRAT, public or private, should be able to take that right away."

From: www,aapsonline.org

Obama Administration OKs First Tax-Funded Abortions Under Health Care Law
Washington, DC (LifeNews.com) - 7/18/2010- The Obama administration has officially approved the first instance of taxpayer funded abortions under the new national government-run health care program. This is the kind of abortion funding the pro-life movement warned about when Congress considered the bill.

The Obama Administration will give Pennsylvania $160 million to set up a new "high-risk" insurance program under a provision of the federal health care legislation enacted in March.

It has quietly approved a plan submitted by an appointee of pro-abortion Governor Edward Rendell under which the new program will cover any abortion that is legal in Pennsylvania.

The high-risk pool program is one of the new programs created by the sweeping health care legislation, Patient Protection and Affordable Care Act, President Obama signed into law on March 23. The law authorizes $5 billion in federal funds for the program, which will cover as many as 400,000 people when it is implemented nationwide.

"The Obama Administration will give Pennsylvania $160 million in federal tax funds, which we've discovered will pay for insurance plans that cover any legal abortion," said Douglas Johnson, legislative director for the National Right to Life Committee.

Johnson told LifeNews.com: "This is just the first proof of the phoniness of President Obama's assurances that federal funds would not subsidize abortion -- but it will not be the last."

"President Obama successfully opposed including language in the bill to prevent federal subsidies for abortions, and now the Administration is quietly advancing its abortion-expanding agenda through administrative decisions such as this, which they hope will escape broad public attention," Johnson said. Full story at LifeNews.com

• Antibody Discovered for 91% of HIV Strains 
   MARK SCHOOFS  Wall Street Journal 7/8/2010

U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered.

Looking closely at the strongest antibody, they have detailed exactly what part of the virus it targets and how it attacks that site. Together with recent research into how to make animals produce antibodies, the new findings constitute a significant step toward an AIDS vaccine.

The antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. Researchers screened 25 million of his cells to find 12 that produced the antibodies.

Now the trick will be for scientists to develop a vaccine or other methods to make anyone's body produce them.

That effort "will require work," said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. "We're going to be at this for a while" before any benefit is seen in the clinic, he said.

The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of the large International AIDS Conference in Vienna, where prevention science is expected to take center stage.

More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates. Vaccines, which are believed to work by activating the body's ability to produce antibodies, eliminated or curtailed smallpox, polio and other once-feared viral diseases, so they have been the holy grail of AIDS research.

CLICK HERE to read article online and comment.

On July 1, Barack Obama spoke of the immigrants who helped build our country—such as my great-grandparents. They passed through public health screening, obeyed the law, worked hard, and never got welfare benefits. They learned the English language and American history. Some even carried the Constitution of their beloved adopted homeland in their pocket throughout their lives. They asked only for the opportunity to contribute.

Should we, as Obama suggested, break down the bureaucratic barriers that hinder such people? Absolutely. That is not what the controversy is about.

The issue is illegal immigration—lawbreaking. Controversy is inflamed by marches of angry people, aggressively waving a foreign flag, insulting Americans in a foreign language, and demanding to “take back” the property and earnings of Americans.

Illegals circumvent public health screening, bringing once banished foreign organisms with them. The most serious one is probably multi-drug resistant tuberculosis, which one can catch on a bus. Head lice are far more common than previously in schools. Dengue has reached the continental U.S. and the parasite that causes Chagas disease now infests more than 40 percent of the kissing bugs found near Tucson, compared with only 4 percent in 1964.

Then there’s property and environmental destruction in the Arizona desert. Ranchers’ land is trampled, and strewn with tons of garbage and human excrement. 

Worse, there are guns—including military assault rifles. Americans are warned to stay out of the Buenos Aires National Wildlife Refuge because it is occupied by heavily armed invaders, who smuggle drugs and humans.  Phoenix, Arizona, is perhaps the kidnapping capital of the world, with heavily armed contingents invading homes and carrying off people for ransom.

While proclaiming that we are “a nation of laws,” Obama didn’t mention how the U.S. federal government encourages lawlessness. One way is by forcing the private sector to care for illegals free of charge, through the Emergency Medical Treatment and Active Labor Act (EMTALA). Physicians on a hospital staff are required to serve these patients immediately—even if they have scheduled surgeries or an office full of waiting patients.

When hospitals in border states complained that this unfunded mandate could cause them to close (as many actually have), the federal government offered some reimbursement for services provided under EMTALA to illegals. Hospitals, however, could not inquire about immigration status—they had to somehow divine it without asking, and file a claim without telling.

Doctors owe a duty of confidentiality to their patients. The Oath of Hippocrates states: “All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal.”

Some things, however, ought to be revealed, and by law physicians must report them. These include certain infectious diseases, gunshot wounds, suspected abuse, and evidence of an impending crime.  While the government demands access to more and more sensitive information about citizens from their health records, including illegal drug use, sexual preference, psychiatric history, and gun ownership, one is not allowed to ask basic questions about immigration status. This is a double standard.

Doctors are not law enforcement agents. Their duty is simply to treat patients—even known enemy combatants or criminals. They may not, however, help people evade the law.

Federal law may actually encourage them to do so. According to anonymous reports, “community health centers,” which are generously funded by federal tax dollars, not only provide treatment to illegals but also may help them obtain many other welfare benefits to which they are not entitled. Bending or violating the law might keep enrollments expanding and the federal dollars flowing and the staff paid. Immigration officials look the other way, and anyone who dared to raise questions would likely be branded as a “racist.” (“ObamaCare,” by the way, will expand the reach of such centers from about 5 percent to 10 percent of the population.)

In contrast to Obama’s examples, like Jews fleeing Eastern Europe, this time we’re not facing just a migration, but an influx having many hallmarks of a foreign invasion.

Individual illegal residents may be oppressed refugees or simply, as Obama says, people seeking a better life. Sympathy for individuals—some of whom might even be hostages or human shields— must not, however, blind us to the threat to our country from harboring at least 11 million “entrants” who have defied our laws.

The system is set up to distribute benefits of lawbreaking. Not just to Obama’s “unscrupulous businesses” but also to politicians who expect to get the immigrant vote, and to bureaucrats, medical professionals, and other citizens who draw taxpayers’ money from the welfare state.

If the United States cannot or does not enforce its laws, Lady Liberty’s lamp will no longer beckon to the people throughout the world who are “yearning to breathe free.”

Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons, has been in solo practice of general internal medicine since 1981 and is a clinical lecturer in medicine at the University of Arizona College of Medicine. She received her undergraduate degrees in chemistry and mathematics from the University of Arizona, and her M.D. from Columbia University College of Physicians and Surgeons. She is the author of Sapira’s Art and Science of Bedside Diagnosis; the fourth edition has just been published by Lippincott, Williams & Wilkins. She also authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown. She is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943. Complete curriculum vitae posted at www.drjaneorient.com.

From AAPS NEWS  6/23/2010
Congress “Solves” Medicare Cost Problem by Not Paying for Doctors

By Jane M. Orient, M.D.  She is the Executive Director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943.

Nine times in the past eight years, Congress has, at the last second, delayed the automatic cuts in doctors’ Medicare fees that it decreed some 13 years ago to prevent Medicare spending from outpacing other consumer expenditures.

The AMA threatens that doctors, especially primary care doctors, will stop accepting Medicare patients if the cuts go through. Congress cites the impending bankruptcy of the program.

Every time cuts are postponed, the next scheduled cut gets deeper. It’s like a balloon mortgage payment in reverse.

And the controversy gives columnists another occasion to rail against those greedy overpaid doctors, unwilling to assume a bit of shared sacrifice despite the economic downturn. 

As Steven Pearlstein writes in The Washington Post, Congress and the President should not accede to these “un-Hippocratic ransoms.” So what if Medicare physician fees haven’t quite kept up with the costs of running the office? What he calls a “modest gap” has been “more than offset” by physicians’ working harder. 

What’s a little 21 percent pay cut to someone who already makes much more than the average patient does? Of course, Mr. Pearlstein doesn’t seem to recognize that when overhead is 50 percent or more, a 21 percent cut in revenue means a cut of 42 percent or more in the physician’s actual pay. And if one is losing $23 per patient visit, it is impossible to “make it up on volume.”

Unlike the AMA, the Association of American Physicians and Surgeons (AAPS) has repeatedly said: Let the cuts go through. But don’t cut off benefits to seniors who see the doctors of their choice.

Both Congress and the AMA appear to be in deep denial about several basic facts:

First, Medicare is insolvent. Expenditures will be cut because the government doesn’t have any money.

Second, the access problem is not caused by the “sustained growth rate” (SGR) formula, but by price controls. If doctors can’t collect enough to keep their doors open, they close, like any other business.

Third, physicians could make more money while charging less, if it were not for the costs of filing claims and complying with Medicare rules.

Fourth, more doctors would do primary care if they could charge a fair price—that the patient was willing to pay—and organize their work in the most efficient way. If they could charge $100 for one long enough visit, instead of churning five patients through frantic $20 visits to bring in $100 without being accused of “upcoding,” doctors would find primary care much more attractive.

We are warned that more doctors will “opt out” if the cuts go through, as up to 200 Texas doctors are already doing each year. Exactly. We need more opted-out physicians to take care of seniors who can’t find a physician willing to work under Medicare’s constraints and threats—or who want a non-government physician.

Congress, however, punishes seniors who choose such a doctor by denying them any reimbursement at all for services they receive from opted-out doctors— or that are ordered by such doctors, even if performed by Medicare providers.

While Pearlstein might be shocked to hear it, doctors opt out of Medicare not because they want more money—many stay in just because they fear a serious drop in income—but because they want to be able to do their job. They want to be able to order what a patient needs, not what a Medicare bureaucrat decides he may have.

Congress apparently intends to cut costs by simply not paying them. Then, if doctors see fewer patients, there are fewer bills for tests or procedures. The government not only saves the $15 it might have paid the doctor, but hundreds or thousands of dollars on tests or drugs.

Fixing the SGR may top the AMA’s agenda. But for seniors, the problem is draconian cuts in care. These can be averted only by restoring patients’ freedom to choose an independent doctor, not by a slight easing of their captive doctor’s shackles.

For more information: www.aapsonline.org

From the AAPS News Letter  6/19/2010 

Pecos Bill
from Truth Serum Blog by Joseph Scherzer, M.D. current President of AAPS

Pecos Bill is a mythical figure of American Folklore. I first learned of him in my doctor’s office. I was 7 years old, suffering from severe asthma, and Dr. Aaron Horland, an EENT (Eye, Ear, Nose, Throat) specialist in my home town of Newark, N.J., had agreed to reduce his fees so my mother could afford to provide me with the allergy shots that may well have saved my life.

HHS urged to pull controversial mammography advice

Radiologists back a lawmaker's demand that the department cease promoting recommendations issued last fall.

By Chris Silva, amednews staff. Posted May 31, 2010.

From AAPS NEWS BULLETIN  6/2/2010

AAPS member and director, Juliette Madrigal-Dersch, M.D., was featured in a spot on her local NBC news yesterday talking about her decision to opt-out of Medicare.  The 21% cut in Medicare reimbursement that again went in to effect on June 1 is leading a growing number of physicians to consider this option.

However many doctors who opt out say it is not because of the money; Dr. Madrigal's fees are less than the price of a haircut and she sees patients over 90 for free.  She once again has the freedom to see her senior patients without the Medicare bureaucracy looming over her shoulder.  Her patients are happier and so is she.

Dr. Madrigal will be a featured speaker at the June 25th AAPS workshop, "Building a Healthy, Independent Practice" to be held in Atlanta.  Visit www.aapsonline.org/atlanta for more details.

Watch the video clip at: http://www.aapsonline.org/newsoftheday/001053

Hospital mass layoffs keep steady pace

The trend mirrors the economy as a whole, although health care traditionally recovers from downturns later than do other industries.

By Victoria Stagg Elliott, amednews staff. Posted May 13, 2010.

From Sacramento Bee 5/22/2010

HIV patients face higher cancer risk

BY DARRYL FEARS Washington Post 

WASHINGTON - When science turned AIDS several years ago from a fatal disease to a chronic illness that often can be managed with drugs, patients and doctors breathed a sigh of relief.

Now they have a new worry. As people live longer with the virus, they are becoming far more likely than the rest of the population to develop cancers that were not previously associated with AIDS, research has found.

"We're seeing high rates of head and neck cancer, lung cancer, kidney cancer, liver cancer and anal cancer," said John Deeken, director of head and neck oncology at Georgetown University Medical Center.

Researchers have detected the trend for years in separate studies around the world, but their findings were not widely publicized or known. On Thursday, the American Society of Clinical Oncology released an abstract by Deeken outlining a clinical trial by the AIDS Malignancy Consortium to study the effects and safety of a chemotherapy drug to treat non-AIDS-related cancers in HIV-positive patients, Deeken said he hopes the presentation of his research at ASCO's June 4 national conference will call attention to a growing cancer threat and the need to address it. Thousands of oncologists from around the world attend the annual conference to discuss new approaches to cancer treatment.

"Even when we control for smoking, we see a higher rate than the general population," Deeken said. "We don't know why this is happening. We need to figure that out."

The development of nonAIDS-related cancers in HIV-infected people could change the way people who are at a greater risk of contracting the virus have come to view the disease. AIDS activists say that advances in HIV drug therapy have led some young gay men to think of the disease as a chronic condition that can be easily managed if they became infected.

Robert Yarchoan, chief of the HIV and AIDS Malignancy Branch of the National Cancer Institute, said that medical advances have saved lives but noted that people with HfV "have to take pills the rest of their lives."

"The pills have side effects he said, "there's premature aging and heart attacks. And now, there are these cancers."

 Health overhaul now used to restrict abortions

Even after the federal health care overhaul is in place, 2 million Californians could still be left uninsured, and the budget-strapped state may find it difficult to absorb millions of others who will wisuddenly have coverage, experts told lawmakers Wednesday.

California has the nation's largest population of the uninsured - 7 million people.

Many of the people without health coverage will choose not to buy it -despite penalties - or are in the state illegally and will not be eligible for subsidies and other government assistance, said Marian Mulkey, a senior program officer with the California Healthcare Foundation, during testimony before a joint session of the state Senate and Assembly health committees.

In addition to the 2 million people Mulkey estimated would continue to lack coverage, another 2 million poor Californians would likely receive it under an expansion of Medi-Cal eligibility

While the federal government will pick up the tab for the 2 million additional enrollees, the state will nevertheless find itself financially stressed to pay for its share of existing enrollees, Mulkey said.

"We face ongoing challenges of maintaining the public programs that we have under the difficult budget challenges that we have," Mulkey said in an interview.

Medi-Cal has been much maligned by health care providers and consumer advocates who say the program is inadequately funded.

Federal health care reform will help extend coverage to more people, Mulkey said, "but it builds on a pretty shaky financial foundation."

On Friday, the Governor's Office is scheduled to unveil its updated budget proposal, and health care advocates are bracing themselves for severe cuts to the state's health care system.

Already, some experts say, California may lack the health care infrastructure - including doctors and clinics - needed to serve millions more people.

"Our health care system will be hard-pressed to deliver that care," said David Maxwell-Jolly, director of the state's Department of Health Care Services.

Insurers are scrambling to comply with key requirements of the federal legislation, including putting in place new insurance coverage standards.

Starting in September, insurers will no longer be able to rescind coverage or withhold coverage because of preexisting conditions.

"We intend to be a constructive voice," said Charles Bacchi Executive vice president of the California Association of Health Plans, "but will be warning you when policies have unintended consequences."

From the AAPS Newsletter 5/12/2010

As Illegals Take,
Are Americans Free?

By Alieta Eck, MD

We do not have "universal health care." We have mandatory free “health care for the universe."
A middle-aged woman came to our local emergency room, suitcase in tow, complaining of a severe headache and diminished vision. A CT scan of the head showed a brain tumor. The neurosurgeon on call was summoned and within days the patient had surgery to preserve her vision.  An inspiring story giving tribute to the wonderful ingenuity, generosity, and high standards in our country?
There’s more.

This woman knew about her brain tumor and had already had an unsuccessful attempt at surgery in her home country.  She booked a flight as a tourist, and her extended family took her directly from the airport to the emergency room. None of them had the slightest intention of paying any part of her bill. American patients, insurance subscribers, and taxpayers will subsidize the hospital, albeit inadequately.  The neurosurgeon will not get paid, but will still be fully liable for any adverse outcome in our medical malpractice environment.

For foreigners, it appears that dishonesty pays. But those who are completely honest have a harder time. The headmaster of a Christian grammar school in Liberia had an abdominal tumor the size of a football. No one in Liberia felt capable of handling such surgery so our church arranged for him to come to that same hospital in New Jersey. Since US government officials knew this man needed medical attention, he was asked to supply letters from the church guaranteeing payment for his surgery. Only then, would the US embassy give him a visa. The church, here, will fulfill its promise and pay a fair price as this is the honorable thing to do. The surgeon will be paid unless he voluntarily chooses to perform the procedure for free, and everyone is uplifted.

There will be those who say they would do anything to get medical care for a loved one. Does this mean they would steal for it? And does their need make stealing right?

Charity is a noble thing, but it cannot be mandated. Our government’s requiring physicians and hospitals to provide free services to whomever walks into the ER does not represent true charity, but a taking of the services from those with valuable skills. The more that is taken, the less charity can be freely given, and all patients suffer as services become less available. Many hospitals now lack neurosurgery coverage for any patient, insured or not.

The proper channels would be for the needy to appeal to those in a position to provide charity, with a culture of generosity arising to meet the need.  We learned quickly that we could not provide access to the United States for every Haitian that needed help. Instead, armies of volunteers have traveled there to help.

While illegal immigrants are not the only ones taking advantage of the “free” services here in the US, the situation attracts those who are willing lie to get something for nothing. Hospitals near the border are especially hard hit, especially by women who forgo prenatal care and show up at the ER in the second stage of labor. An added attraction is automatic American citizenship for the child. Births to illegal alien mothers constitute nearly 40% of all births paid for by Medi-Cal. Dozens of hospitals along the border in California, Arizona, New Mexico, and Texas have been forced to close or go bankrupt because of the unfunded federal mandate to provide free care to Illegals.

The Arizona state government has passed a law making it a state offense to cross the border illegally.  It is already a federal offense.  How else should Arizona respond when the federal government does not take seriously its constitutional obligation to protect the US borders?

Our forefathers came to this country with only the shirts on their backs, expecting nothing but an opportunity to work in freedom. They did not demand free services but worked alongside hardworking Americans to build their own American dream. That was always the promise of America and we need to be vigilant lest we lose it.

Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ

www.aapsonline .org

Anthem

hikes, cites bad math

"ABOUT THE ISSUE
Anthem Blue Cross backpedaled Thursday from its plan to raise health insurance premiums up to 39 percent, after a review ordered by Insurance Commissioner Steve Poizner.Who is affected?

On Mar 26, AAPS filed suit in the U.S. District Court for the District of Columbia r. Sebelius, et al. No. 1: 1 0-cv-00499- RMC), asking for the following relief:

Vacate the provisions in the Social Security Program Operations Manual System (POMS) that require AAPS members and their patients to participate in Medicare Part A as a condition for receiving Social Security benefits.

Order Secretary Sebelius and Commissioner Astrue to submit to the Court an accounting on the solvency of Medicare and Social Security, respectively.

AAPS writes that "many patients prefer to avoid Medicare... because the quality of care is better... outside" the program. Additionally, physicians prefer to operate outside Medicare because of its restrictions on the practice of medicine.

Although mandates do not take effect until 2014, the addition of major new costs then is lowering the value of businesses today.

Nothing in the U.S. Constitution authorizes the federal government to set the acceptable terms of health insurance. By forcing up premiums generally, federal standards represent a regulatory_* taking, without just compensation, in violation of the 5th Amendment, AAPS argues.

Defendant Sebelius knowingly stated that PPACA would reduce the federal deficit, when she knows the opposite is true in reality, without the unrealistic assumptions that the Congressional Budget Office (CBO) was compelled to make in PPACA. Congress purports to cut half a trillion dollars from Medicare. This program faces fiscal insolvency; the Secretary has a fiduciar duty to implement federal programs properly, and Americans need an honest accounting (www.aapsonline.org/hhslawsuit).

BY BOBBY CAINA CALVAN bcalvan@sacbee.com

"The U.S. Department of Justice won't stand in the way of a long delayed layed project aimed at shining a light on California's rising hospital costs.
That means CalPERS and some of the state's largest health care purchasers can proceed with plans to launch an extensive study into the cost of providing care for more than 300 hospitals statewide.

The California Hospital Association had attempted to block the, project, saying it violated federal ant-trust laws by potentially releasing, proprietary data that could hinder competition within the health care industry.

On Monday, the Justice Dcpartmentment sided with CalPERS, the Pacific Business Group on Health and the California Health Care Coalition, the entities planning to under-write the Hospital Value Initiative

Brad Pacheco, a spokesman the California Public Employees Retirement System, welcomed the Justice Department's decision, saying "it reinforced the importance of transparency ."

CalPERS is the country's second largest buyer of health care service spending more than $5.7 billion a year on health benefits for 1.3 million state and local government employees, retirees and their families

Jan Emerson, a spokeswoman for the California Hospital Association declined to be interviewed but said in an e-mail that the announcement by the Department of Justice "does not resolve the anti-competitive concerns California hospitals  have about this initiative."

Emerson said the project's focus on cost was too narrow and said quality of care should also be taken into account.

Because of the antitrust concerns the initiative had been in limbo since 2007, pending goverment review....."
Call The Bee's Bobby Caina Calvan, (916) 321-1067.

-----------------------------------------------------------------------------------------------------------

From The Greg Scandlen News letter 4/28/2010

Hospitals  [in reference to the New Health Care Reform Law]
 
It seems hospitals are getting hosed, too. Or at least they are "Scared to Death," according to the Health Data Management blog. The quote comes from the CEO of the biggest hospital chain in Illinois during a conference of health care journalists in Chicago.
 
Blog author Greg Gillespie writes, "What's frightening to Skogsbergh and his peers is the uncertainty surrounding so much of the legislation, and the one certainty: providers are going to be paid less, whichever way you slice it." The huge expansion on Medicaid means that hospitals will get paid an average of 50% of their costs, plus they will not be paid at all for "readmissions," which happens to 22% of all Medicare patients according to the hospital administrators.
But most of all, one analyst estimates there will be ten pages of regulations for every page of the law itself, [2700 pages]   so no one can anticipate what they are expected to do.
 
Perhaps the CEOs should have a word or two with their lobbyists at the AHA who helped bring us this mess.
 
SOURCE:
Health Data Management blog

Older baby boomers sicker, using more care than earlier generations

Many people age 55 to 64 have chronic conditions, but technological improvements have widened their health care options.

By Victoria Stagg Elliott, amednews staff. Posted April 19, 2010. 

• The oldest end of the baby boom generation, people now age 55 to 64, is consuming health care in greater amounts than same-aged individuals did in prior generations, according to a March report by the Centers for Disease Control and Prevention's National Center for Health Statistics.

Can You and Your Doctor Thrive without Medicare and Insurance Plans?

READ ARTICLE ONLINE & COMMENT
www.aapsonline.org.

By George Watson, D.O.

(Note: Dr. Watson spoke at the Salina, KS teaparty last week.  Click here to watch a video clip.)

Patients and doctors need to ask: what should a medical practice be like?

For doctors: Would you like more time with your patients; fewer or no insurance company hassles and prior authorizations, and less paperwork? Would you like to determine a fair price for your service, together with your patient? Would you like your daily receipts to equal your daily charges? Would you like to be called “Doctor” rather than “Provider”?

For patients: Is this the kind of doctor you would like to have? And would you like your current doctor to stay in practice? If so, you should ask your doctor to carefully consider this article. It might enable him to be there for you.

Many doctors are now at the fork in the road where I found myself seven years ago. I had completed the certification exam in age-management medicine, and began to offer services that the insurance companies said were “non-covered.” Overhead continued. Receipts went down.

On the verge of bankruptcy, I received a flyer titled “Thrive, Don’t Just Survive,” so I charged my airline ticket and room to my credit card and went to check it out. I heard a family physician tell how the HMO’s turned the screw one more notch and bankrupted half of the family practices in the state. Then he told how he turned the situation around.

He now had joy in serving his patients, and was collecting a fair price at the time of service. I thought, “Sure, a family physician could do that, but it wouldn’t work in any specialty.” Then an orthopedic surgeon and an urologist told similar stories of how they too were really enjoying medicine after they opted out of Medicare and all insurance contracts. I thought, “If they can do it, I can too!”

By God’s Grace, the office I had formerly used was going to be vacated in two months, and the lessee still had lease obligations. The equipment there, which I had sold them when I was called up for Desert Storm in 1991, was going into storage, as the doctor was moving to a newer, better equipped facility. I took over the lease in return for the equipment October 1, 2003, I started over with one employee and no patients. (Like many recent government appointees, I even owed back taxes). I bought supplies and signage with credit cards.

I bought a 10 second co-op ad on the local Fox channel that said, “Imagine, a 5 minute doctor visit for $20!” We handed out flyers to local businesses. I met with business owners, explaining that I was 100% committed to them and their employees, not the insurance companies.

My employee and I painted rooms when we weren’t seeing patients.

Starting from less than zero, I made a profit in month five. A doctor who kept all but 20% of his patients, but cut out insurance overhead and write-offs, could be profitable the very first month. The patients who stayed would be choosing their doctor—not picking an insurance company doctor from a list.

In 2006, I bought out another doctor in Hays, Kansas, which required that I buy a Mooney 201 airplane in 2007. In 2008, I bought a Dexa bone scanner to complement my Thermography service. And this past June, I bought a new Expedition to keep my taxable income as low as possible.

Today some of my patients ask, "How will the new health law affect you? You won’t quit, will you?"

Of course I won’t. My practice is what I dreamed of when I started medical school. I work for my patients—not the insurance company or the government!

Many doctors will not have the courage to change course. But if they continue taking money from third parties, people like the government’s “recovery audit contractors” will stick the fork in them.

Doctors need to take the fork that is—so far—less traveled. And patients need to find such a doctor. Insurers may have intimidated doctors so they believe they can’t survive without signing every contract. The fact is, patients and doctors need each other, but doctors don’t need those contracts.
Both patients and doctors need to declare independence.

"Not only is the public confused, but so are our members," said Dr. Lori Heim, president of the American Academy of Family Physicians, which supported the bill. "There's been a lot of misinformation out in the media. We've been trying to get to them simple answers -what does this mean for my practice, what does it mean for my patients, what does it mean for the future?"

Some doctors said their patients were pushing for surgery immediately, for fear that it will not be covered in the future or that they will end up on a waiting list."It's ludicrous to be coerced to perform surgery because of fear of non-coverage in the future," said Dr. Eustaquio Abay II, a neurosurgeon in Wichita. "I refuse."

While many doctors say they are not besieged, the queries have been particularly robust in states where the plan was unpopular, Heim said.

For many doctors,. the big frustration comes when they do not know what to say to their patients.

From Sacramento Bee, 4/14/2010

Waxman Inquisition over new health law drips of hypocrisy
by: Margaret A Bengs, a former political speechwriter at  www.peggy/benz@hotmail.com

"On Aprril 21.California Rep.Henry Waxman ,Chairman of The House Energy and Commerce Committee, wii nterrogate the heads of Caterpillar, Verizon, AT&T, Deere and other corporations on their announcement that the removal of a tax subsidy on retiree drug-benefit plans in the new health care reform law will cost them hundreds of millions of dollars - AT&T alone taking a $1 billion hit.

AT&T, which employs more than 46,500 people in California, will consider changes to its "active and retiree health care benefits." Waxman's planned inquisition is reminiscent of the February hearings in Sacramento and Washington, D.C., where politicians vented outrage over Anthem Blue Cross's 39 percent rate hike.

"Breathtaking," Waxman pronounced it.

What is truly breathtaking is that members of Congress, including Waxman, who preside over federal debt expected to reach $15 trillion over the next 10 years, trillions more in unfunded liabilities for Medicare and Social Security, and a $1.3 trillion budget deficit in the current year before adding the new $1 trillion health care entitlement, dare to offer themselves up as judges of sound fiscal practices.

If we are going to cross-examine Big Business for rate hikes and cost increases, why shouldn't we grill Congress about Big Government's unsustainable spending binge and insolvent programs? Is the government morally pure while the private sector is evil? The money taken out of our pockets is the same, whether by a company or an IRS agent. And government's take makes the corporate cost write-offs in question equivalent to a grain of sand on a San Diego beach...".

"...In 1965 Congressional Budgeters predicted that Medicare would cost $12 billion in 1990. Instead, it rose to $90 billion, according to a Wall Street Journal analysis. Medicaid now costs 37 times more than it did'when it was launched.

The idea that taxing the "rich" will pay for the deficits and debt politicians have run up is another pipe dream. Just to pay for the current year's federal deficit alone, top rates would have to reach 84.9 percent, the Tax Foundation reports, and average tax payments would have to rise by almost $10,000.

And, if you think you're paying a lot of taxes this year, next year will be worse. President George W. Bush's tax cuts will expire, so taxes on income, capital gains and dividends will rise - likely to depress investment just when we need it to create more jobs.

While the new health law offers tax credits to small businesses that provide health insurance, it also imposes Medicare tax hikes on those in higher-income brackets, including a new Medicare tax on investment income, as well as taxes on medical devices and other tax increases. White House economic adviser Paul Volcker also just floated the idea of a "value-added tax" - a form of national sales tax - on top, of all the taxes we currently pay.

If we are going to hold Big Business accountable for accurate bookkeeping, we should hold Big Government accountable for its broken promises and fiscal recklessness.

BY CARLA K JOHNSON Associated Press

After four years in nursing school, Cockrell spent another three years in a nurse practitioner program, much of it working with patients. Doctors generally spend four years in undergraduate school, four years, in medical school and an additional three in primary care residency training.

Medicare, which sets thepace for payments by private insurance, pays nurse practitioners 85 percent of what it pays doctors.

The health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100 percent of what obstetrician-gynecologists make - and that may be just the beginning. States regulate nurse practitioners and laws vary on, what they are permitted to do:

• In Florida and Alabama, for instance, nurse practitioners are barred from prescribing controlled substances.
• In Washington, nurse practitioners can recommend medical marijuana to their patients when a new law takes effect in June.
• In Montana, nurse practitioners don't need a doctor involved with their practice.
• Many other states put doctors in charge of nurse practitioners or require collaborative agreements signed by a doctor.

n In some states, nurse practitioners with a doctorate in nursing practice can't use the title "Dr." Most states allow it.

In California, nurse practitioners provide care under the supervision of a physician.

Last year, California lawmakers signed legislation that expanded nurse practitioners' authority, allowing them to order durable medical equipment such as walkers, to certify disability in collaboration with a physician, and to approve home health services treatment. Also last year, the California Board of Registered Nursing started requiring nurse practitioners to have a master's degree.

What's the evidence on the quality of care given by nurse practitioners? The best U.S. study comparing nurse practitioners and doctors randomly assigned more than 1,300 patients to either a nurse practitioner or a doctor. After six months, overall health, diabe

tes tests, asthma tests and use of medical services such as specialists were essentially the same in the two groups.

"The argument that patients' health is put in jeopardy by nurse practitioners? There's no evidence to support that," said Jack Needleman, a health policy expert at the UCLA School of Public Health.

Other studies have shown that nurse practitioners are better at listening to patients, Needleman said.

The American Medical Association is fighting proposals in states that are considering steps to expand what nurse practitioners can do.

"A shortage of one type of professional is not a reason to change the standards of medical care," said AMA President-elect Dr. Cecil Wilson. 'We need td train more physicians."

I

From Los Angeles Times

Healthcare overhaul won't stop premium increases
4/13/2010

"The new law doesn't prevent rate hikes such as Anthem Blue Cross' double-digit increase last year. 'It is a very big loophole,' says Sen. Dianne Feinstein, who is pushing regulatory legislation.

Reporting from Washington

Public outrage over double-digit rate hikes for health insurance may have helped push President Obama's healthcare overhaul across the finish line, but the new law does not give regulators the power to block similar increases in the future.

And now, with some major companies already moving to boost premiums and others poised to follow suit, millions of Americans may feel an unexpected jolt in the pocketbook.

Although Democrats promised greater consumer protection, the overhaul does not give the federal government broad regulatory power to prevent increases.

Many state governments -- which traditionally had responsibility for regulating insurance companies -- also do not have such authority. And several that do are now being sued by insurance companies.

"It is a very big loophole in health reform," Sen. Dianne Feinstein (D-Calif.) said. Feinstein and Rep. Jan Schakowsky (D-Ill.) are pushing legislation to expand federal and state authority to prevent insurance companies from boosting rates excessively.

At least in the short term, regulators will be able to do little more than require insurers to publicly explain why they want to raise rates. Consumer advocates think that will not be an effective deterrent against premium increases such as the 39% hike that Anthem Blue Cross sent some California customers last year.

"The irony here is that it was the Anthem rate increase that breathed new life into the healthcare bill," said Jerry Flanagan, medical policy director of Consumer Watchdog, a longtime supporter of tougher premium regulation. "But there is nothing in this bill to guarantee that it doesn't happen again."

The lack of muscle is stoking concerns that more rate jumps -- and an angry backlash from ratepayers -- could undermine support for implementing the healthcare overhaul.

Insurance industry officials say that talk of more regulation is misguided and have urged federal officials to focus instead on containing rising medical costs, which help drive up premiums.

"Politicians are much more comfortable looking at healthcare premiums," said Karen Ignagni, president of America's Health Insurance Plans, the industry's Washington-based lobbying arm.

Ignagni, as well as some independent healthcare experts, said policymakers should look at ways to control what hospitals and other providers charge, although few elected officials have shown much appetite for doing so.

Obama endorsed Feinstein's insurance proposal this year, including it in the healthcare blueprint he unveiled in February as Democrats were struggling to revive their proposals. But congressional rules prevented Democratic leaders from including the rate control provision in the final healthcare package.

Many consumer advocates think this enhanced regulation -- known in the industry as "prior approval" authority -- is the only real way to protect ratepayers from insurers, particularly for-profit companies under pressure to generate returns that satisfy Wall Street investors.

Prior approval requires insurers to submit proposed rate increases to regulators, who can then comb through companies' financial and actuarial data to see if the proposals are justified.

Insurers cannot raise premiums without explicit permission from the regulator.

Some states have given prior approval authority to their insurance commissions and have used it to force down premiums.

In New York, the state insurance department reduced nearly a quarter of the proposed premium increases between 1990 and 1995, according to a recent department analysis.

More recently, state regulators in Kansas successfully pushed Blue Cross Blue Shield of Kansas to reduce a proposed premium increase for some of its elderly customers, according to state Insurance Commissioner Sandy Praeger.

California, which does not have the power to block health plan increases, has been using similar authority to control property and auto insurance premiums for more than 20 years, said Dwight M. Jaffee, a real estate and finance professor at UC Berkeley's Haas School of Business. "It has been very successful," said Jaffee, who studied the state's experience.

Health insurance, however, is more complicated than property and auto coverage. And even the most active state regulators typically cannot investigate every proposed change in every segment of the insurance market...."