New federal regulation in HHS concerning conscience rights

"This is an election (2022) about power and control," said Planned Parenthood. I rarely agree with PP, but that's one comment, although they mean the opposite of what I believe, they are right about. Power to kill AND control your religious and speech rights guaranteed by the Constitution.

The Biden administration which is bankrolled by powerful organizations like the teachers' unions, Planned Parenthood, NARAL, Emily's List, wealthy woke corporations and Soros backed entities, is proposing a new HHS rule which would force doctors, nurses and healthcare professionals to perform-participate in abortions, transgender mutilations and other procedures pro-life conservatives (and probably many Democrats who are Christians) consider morally bankrupt, cruel and sinful. By law, even morally stunted bureaucrats must accept comments on rules like this. Make your voice heard. Don't just comment your outrage to your friends on FB, tell Joe how you REALLY feel about being forced to participate in sin. Regulations.gov. 

When you look at "conscience protections" we already have it's hard to believe we'd go through this again, but the pro-death forces are very well organized, financed and backed up with clever lawyers (in the N.T. they are called Pharisees and Sadducees). It will be "found" in the Affordable Care Act (aka Obamacare). If the rule passes, it could close hospitals and end the careers of many fine doctors and nurses and healthcare staff. Maybe you are undecided on transgender/affirmation thought, but would you assist in removing the healthy breasts of a middle school girl, or castrating a little boy at the request of his parents or social workers? It's the ultimate child abuse.

The only Christians that seem to be well organized enough to fight this and sound an alarm are the Catholics. I could find very little on it, but here's one https://www.americamagazine.org/politics-society/2022/04/05/transgender-abortion-hhs-242759 If your church or denomination has a bioethics department, check with them. If not, take it to your Sunday School class. This is our abolitionist movement. Don't be caught asleep at the switch.

This is the government double speak that describes this: HHS Announces Proposed Rule to Strengthen Nondiscrimination in Health Care | HHS.gov. These days all victim theories are put in the context of the civil rights rulings, a huge smokescreen. This at least assures you it is Joe Biden's doing through an executive order. It twists the meaning of "restores rights" "stands up for" and "affirms"--the bureaucrat who wrote this must have grown up on 1984 Newspeak.

Philosophical Puzzles about Transgenderism — The National Catholic Bioethics Center (ncbcenter.org)

We’d met before, when he was not a happy camper

I'd seen an article in the Columbus Dispatch, and decided to write a note to a doctor who was mentioned as the expert. I've been fiddling with the draft for a week or so, when finally it dawned on me his name sounded familiar. So I did one of those internet people searches where public information is collected on one site, and sure enough, I used to work for his mother. We'd actually met. I had attended his bris, the Jewish ceremony in which a baby boy is circumcised.

Women surgeons

It's a cottage industry. Seeking out victims. Women outnumber men in medical school, law school, pharmacy and veterinary medicine. 40% of U.S. physicians are women (not sure those sexist stats are going to be collected indefinitely). 80% of veterinary students are women. But it's never enough. Today I got an e-mail from OSU about the 4th annual Women in Surgery Symposium and the focus? You guessed it. Workplace inequalities, bullying and microaggressions. This constant agitation by mushrooming "education" agenda driven non-profits is so lucrative, it will never go away. Maybe you'd better interview your surgeon before submitting to the knife. Make sure she isn't angry or stressed.

The gender gap is a mommy gap

It's not a pay gap, it's a mommy gap. A choice gap. "43% of highly qualified women with children are leaving careers or off-ramping for a period of time." ("Lean in" by Sheryl Sandburg) And I know this is difficult to understand, but a baby is a whole lot more fun than attending meetings, rushing to catch a plane, or listening to office gossip. So many women cut their hours, at least for a period of time, to enjoy their children rather than put them in day care or send them off to grandma's. That of course, means their salaries don't keep up.

I see my doctor tomorrow--she's only working 2 days a week since she had a baby last year. And it's her choice--it's an all female practice, and I think they are all doing that. Now if you want to study gaps, check out the difference the all female clerical staff who work full time, make compared to the doctors who are working 2/5 time.

From vice to substance abuse disorder in 100 years

JAMA (Oct. 24/31, 2017) had an interesting opinion piece, "A death in the family" about a doctor who overdosed on fentanyl. It was a tragedy for his colleagues, family, friends, and thousands of future patients who will never benefit from his skill. But it was also a tragedy for the English language and our search for someone to blame. "Overdose on fentanyl?" "substance abuse disorder?" "stress and burnout?"

Remember when poverty was blamed for drug use--it was a ghetto problem? Remember when it was the pathology of the black family and its roots in slavery? Remember when it was poor parenting and kids hadn't been raised right? Or, they just need Jesus? Or going way back, remember when opium was blamed on "vice" (i.e. Asians)? Or today's news--the drug lords (Mexican gangs)?

30 years ago when I was employed at the vet college I learned that veterinarians had a higher suicide rate than physicians, and women higher (in attempts) than men, but the reasons given were different; the grief and sadness the same.

I certainly don't have the answers, but then, neither has anyone else the last 50-60 years, and that's small comfort.

This article contains a good list. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266064/

Partial view of the JAMA article. https://jamanetwork.com/journals/jama/article-abstract/2658326

Comments on the "Muslim Ban" from Medpage

Don Lynch:  "I guess first I would like to say it is not a Muslim ban. If it was there are countries with a higher number of Muslims that would have been on the list. It was an attempt to get a better hold on people with ill intent for America. It has happened before. And I would be negligent if I didn't mention that The President of the United States may have better information on the currant security risk and where they are coming from then us mere mortals. ( And NO he wouldn't tell the people as it would just tip our hand on just how must information we have on the bad guys operation.) That being said, he also mentioned this was just for two months, any questionable entries would be handled on a case by case basis. Like someone coming here for emergency surgery. During this short two months he was hoping to have a handle on things after meeting with security around the globe, and his own cabinet. But that might be delayed while politics are delaying The Presidents Cabinet. This is all being done at the risk of Americans. He didn't want to act globally until he had the necessary information in hand. And now we have judges making up law the way they think it should be. So we'll all wait (with our pants down around our ankles leaning across the table) until we get in front of a judge that reacts to The Constitution of the United States, and not one that dispatches law the way he wants it to be."

I saw this response in a comment about 12 medical organizations at MedPage objecting to the travel restrictions from seven terrorist countries.  I do wonder why the U.S. is either 1) borrowing their doctors when they need them so much, or 2) training their doctors to be sent back into the meat grinder.  Of course, we can be pretty sure they won't go back.

MACRA and DREXIT

The latest government acronym that will increase your medical cost and lower your quality of service is MACRA, The Medicare Access and CHIP Reauthorization Act of 2015. It was signed into law over a year ago and is the “law of the land” now with overwhelming bipartisan support in Congress and with much lobbying and cheerleading from medical associations. Obama even joked about having Republicans on board.  And MACRA is very lengthy and very detailed legislation. 962 pages. Does your doctor have time to read it? Efficient, quantifiable, homogenized, controlled and dehumanized. We might get a Drexit. http://hitconsultant.net/2016/07/19/34815/

http://www.forbes.com/sites/theapothecary/2016/07/21/last-years-medicare-doc-fix-is-already-breaking-down-here-are-some-new-fixes/#dff7517154cc

"As many as 58 percent of surveyed physicians would opt to join a larger organization to mitigate individual risk and have access to a greater array of resources. Eighty percent saw physician consolidation as an inevitability under MACRA, with half of physicians viewing financial pressures as the top driver of consolidation."  I suspect this is the true purpose of MACRA.  No independent doctors. https://ehrintelligence.com/news/physician-readiness-for-macra-implementation-found-wanting

The list of suggestions for change looks as long as the legislation. http://advocacyblog.acponline.org/2016/06/macra-solutions-versus-macra-rants.html

This doctor won't accept Medicare because. . .

This is no way to treat people who have dedicated their lives to helping others.

• Medicare treats physicians as criminals—guilty until proven innocent.
• Medicare warns patients on their billing statements to turn their physicians in for suspected fraud.
• Medicare demonstrates no transparency in the flow of taxpayer money through their program.
• Medicare may reimburse physicians so little that we lose money with each appointment forcing doctors to go bankrupt (or run Medicare mills with ramped up volume and quickie visits to make ends meet).
• Medicare claims are more complex than any other insurer with more billing codes and rules and regulations that require hiring a team of staff to remain compliant or else . . .
• Medicare regulatory codes by which physicians must abide is 130,000 pages long! (US Tax code is only 75,000).
• Medicare requires compliance with more unfunded mandates and administrative trivia than any other insurer.
• Medicare penalizes physicians financially if we don’t use a Medicare-approved computer system and electronic health record.
• Medicare penalizes physicians financially if we don’t electronically submit prescriptions the way Medicare demands.
• Medicare threatens doctors every year with all sorts of financial penalties if we don’t do what they (non-physicians) think we should be doing.
• Medicare audits may suddenly destroy a medical practice and a physician’s life as described by Dr. Karen Smith.
• Medicare abuses and bullies doctors.

Check out the web page for Dr. Pamela Wible, M.D.

Fallout from Obamacare—we’re losing doctors

My husband saw a medical specialist today who had an interesting story, which she said she can't tell her children because they are all Democrats and think Obama walks on water. She said that for the first three months after signing up for Obamacare (we live in Ohio, of course), the person isn't charged premiums (or at least they aren't due). So they get a lot of medical care during that time, then by the time the insurance claims make it through the system for payment to the doctor, they haven't paid their premiums and the doctors don't get paid. Neat scam, right? So how many doctors do you think will take Obamacare enrollees as new patients? Dr. Meenam says, “Absolutely true, and the doctors are not given any notice that the patient is delinquent, just told to send back the payments they have received if the patient who had services doesn't pay.”  She got out of medical care before Obama’s plan kicked in.

Doctors pressured to push Obamacare

"With open enrollment set to begin next week, enrollment groups and medical societies are hoping America's doctors can inform patients about their options for expanded coverage under the 2010 health law." Medpage.

So far, I haven't met a doctor who liked Obamacare or thought it was a good idea, so why ask them to push it? Some plan to by-pass insurance plans all together.

So I asked self, "I wonder what an 'enrollment group' is?" I looked it up, and here is one called "Enroll America."

"Enroll America is a nonpartisan 501(c)(3) organization whose mission is to maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act. Enroll America is a collaborative organization, working with partners that span the gamut of health coverage stakeholders—health insurers, hospitals, doctors, pharmaceutical companies, employers, consumer groups, faith-based organizations, civic organizations, and philanthropies—to engage many different voices in support of an easy, accessible, and widely available enrollment process."

You should see the fancy website. My goodness--one of the best. Clicked all over the page, but not a peep on how it is funded (except the donate button, and I seriously doubt this staff, offices, website, training sessions, etc. are covered by donations). I bet this group didn't wait 3 years for their non-profit tax status.

America has been at war with its doctors for a decade

“The fundamental paradox of the regulatory state in medicine is that physicians face constant impediments to the actual care of patients.”

“a cultural assault on [doctors’] their fundamental spirits of risk-taking, innovation, and professional autonomy.”

“a gross devaluation of the economic value of their work. Minimal pay from insurers – particularly Medicare and Medicaid – for life-or-death work is the new norm.”

“there is an army of non-physicians, now known as providers, waiting at the ashes of the battleground of America and its physicians.”

Mona Kotecha, MD

And from Bev, who is caring for her 90 something parents:

I have several stories to tell... Even if you have always been able to afford health insurance, the rules of the game have drastically changed in the last three years. If a specialist you have seen for 20 years does not take the new insurance the government forced you to buy you cannot pay out of pocket to stay with that provider. You must get a referral from your GP (if you have one that takes your insurance) and start all over with a new specialist.The GP must send a new referral every year to the specialist. I was told recently by a doctor that with all the insurance possibilities out there I was foolish for picking an HMO for my parents.  Apparently an HMO causes paperwork nightmares for that doctor's staff. When both parents are ninety and have ongoing health concerns you cannot shop around. Because of the government and insurance the doctor loses and the patient loses. It is a lose-lose situation.

Those of us who are considered seniors are a drain on the health system anyway according to the new health laws. I think I studied something about what ultimately happened to those who were found unfit and a drain to society in high school and college history classes. It has been a bad two weeks for me navigating our new improved insurance and medical system.

Get ready for a third world experience—or medical care

Obamacare is three years old, but what terrible tantrums this oversize, clumsy youngster is having. Premiums going up, employers shrinking their work force, doctors retiring early, and young people who might have become doctors are selecting a different career route. The insurance exchange official (Chao) in charge is hoping it won't be a third world bureaucratic experience. And we're hoping we haven't been downgraded to 3rd world medical care, but wouldn't that be "fair" in the president's eyes?

http://www.forbes.com/sites/aroy/2013/03/22/cms-on-obamacares-health-insurance-exchanges-lets-just-make-sure-its-not-a-third-world-experience/

A plan doomed to fail

No shock here. If the federal government passes enough mandates, and the states can't print money, soon there is no money for the poor.

"Obama administration officials said Friday that the state-based “high-risk pools” set up under the 2010 health-care law will be closed to new applicants as soon as Saturday and no later than March 2, depending on the state." reported in Washington Post today.

The plan is set up to fail--whether intentional or not. The wait to get in the high risk pool means the people are desperately sick by the time they get coverage, and very expensive to treat, thus depleting the money for those waiting. Bad, bad plan that only a massive bureaucracy could come up with.

And ultimately, it is the same plan for the rest of us.  Doctors are quitting rather than go along with the insane regulations—the documents to support this massive bill run to thousands of pages. 13,000 pages as of October 12 and 18 pages to define a full time employee.  There aren’t enough to meet the Obamacare guidelines and new doctors probably won’t materialize.  By the time we get to see a doctor, we’ll be too sick for effective treatment.

The government will add more snoops and IRS agents than doctors or nurses.

Obama needs to check the stats

Violent crime is way down since 1994 among the young, but Obama will never look at the stats. Doesn't fit his template of ripping the country apart by creating animosity among groups, races, genders, and religions. Now he wants to put in place a plan that will discourage people with depression or anxiety or bi-polar disorder from getting help because they fear being manipulated in a federal database. He's turning their doctors into snitches.

http://bjs.ojp.usdoj.gov/content/pub/pdf/vcay9410.pdf"

www.caintv.com

"Is there anything in Obama's proposals to take your 2nd amendment rights that would have saved the children of Sandy Hook? How about the 100+ black children in Chicago killed 2011-2012?"

Faith--in electronic health records

Some people riducule those of us who place our faith in God. How about those who place faith in electronic health records to solve a myriad of problems in the health "system." The faith we the people/patients, the medical community and the federal government put in electronic health records is just amazing. Here's a brief list--you can probably think of more.

• reduce costs
• track physicians' performance
• improve decisions at all levels
• connect patients with caregivers, clinical staff, care coordinators
• 24/7 access to medical help
• special clinic access
• e-mail, wireless, monitoring of patients
• home evaluations
• improved nutrition and exercise compliance
• transportation services

Noticed in an editorial in JAMA, Jan. 4, 2012--not that the author claimed to have faith, but was simply musing about all the wonderful thing EHR would bring. Any chance $27 billion in stimulus funds stimulated this faith? It looks like just another way to kill off the small medical practice by raising their costs beyond which patients can tolerate.

Having practiced medicine in both paper and electronic environments, [Jaan] Sidorov says an EHR for a group practice is, at best, a wash economically-even with federal incentives. "The cost of these systems is eye-popping, and while the price has fallen, the total bill still includes hardware, software and support. Common sense about the flow of patients and economics doesn't make me believe that doctors can recoup these costs on the back of patient billing."

And if the economics at the group practice level are murky, the prospects of lowering overall health care delivery costs is downright farfetched, Sidorov says. "On the macro-economic level, we are moving chairs around on the deck of the Titanic."

Much more here.

Jaan Siderov's blog, Disease Management Care

Access Board to Set Standards for Medical Equipment under the Health Care Reform Act

All my husband's announcements for continuing education come to my e-mail, and increasingly most are actually offered on-line. The ways manufacturers find to be either "green" or "sustainable" are just amazing. As are the health and safety reguations. In looking through them I noticed one for ADA compliant workshops for a product to assist the blind (little raised bumps on walkways). As I was browsing through the product literature I came across the "Access Board" website for the federal government. The Obamacare (PPACA) is almost full employment for industries that supply anything medical, from workshops to lighting to equipment to computer records, and they will successfully put the small medical offices out of business and force patients into group practices and then push them to government health care when those also get regulated out of business. Imagine the cost for a one or two doctor clinic for just this one requirement while they are still paying off their college loans and the mortgages on the equipment purchased last year:

"The "Patient Protection and Affordable Care Act" authorizes the Access Board to develop new access standards for medical diagnostic equipment including examination tables and chairs, weight scales, x-ray machines and other radiological equipment, and mammography equipment. Access to such equipment has been problematic under the Americans with Disabilities Act (ADA)."

Access Board to Set Standards for Medical Equipment under the Health Care Reform Act

Attention Boomers! Where is your doctor?

USAToday reports, "The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program." Can you believe there's not a word in this article about why or who caused this, only that Congress has failed to stop an automatic 21% cut in payments that doctors already regard as too low. Where did that come from? Is this more Cloward and Piven--try as hard as he can to make everything break at once?

The CMM will tell you 3% don't accept Medicare, but in Illinois it's 18%. 19% of DOs won't accept new patients.


Doctors limit new Medicare patients - USATODAY.com
HT Murray

Decisions about disclosure

The opening paragraph of an essay titled, "Disclosure" by Dr. Rochelle P. Walensky of Boston in the May 5, 2010 issue of JAMA was stunning in the author's lack of understanding her role in protecting the general public and specific individuals from serious disease. Others I'd give a break, but she had an MD and MPH after her name! The paragraph really wasn't essential to the thrust of her topic, which was about being a woman (pregnancy, motherhood) in academic medicine. Here's what she wrote:

"Early in my career, one of my patients with HIV infection, Robin, a recovering heroin addict, had re-enrolled in school and was newly engaged. Her fiance was unaware that she was HIV infected and she would not discuss using condoms, let alone her HIV infection, with him. I encouraged her to confide her infection to her fiance--for the integrity of their relationship and for the value of his health--at each of our clinical encounters. Finally, she did so. He left her. She stopped taking her antiretroviral medications and restarted using heroin. Although the fiance may have reduced his risk of infection, the consequences of my intervention were tragic for my patient. Robin's case reinforced that disclosure is a risky business because the truth can trigger an unexpected, sometimes devastating chain of reactions."

No, it wasn't unfortunate that the fiance left her; it probably saved his life, assuming he wasn't already infected. No, Rochelle Walensky's intervention as a doctor and public health official wasn't tragic--it was probably a requirement of her job! No, Robin didn't start using heroin again because her fiance left her--she was an addict and no one, not even the love of a good man could change her if she wasn't up to the tough behavior needed to kick it. No, stopping the antiretroviral meds wasn't a tragedy because she would just become reinfected as the heroin addiction took over her mind. Part of getting well is a behavior change, chastity and monogamy, something she can't do on drugs. And finally, it's just entirely possible that the fiance left her because he realized she valued his life so little, that he would never again be able to trust her.