Scary Christian writer?

I was surprised to hear a Christian writer I respect say that Trump's first 100 days were the scariest he's experienced -- referring to tariffs and Doge (I think was his reasoning). 

Really?

 
Scarier than 9/11?

Scarier than Biden's bugout in Afghanistan?

Scarier than the enormous increase in medical costs and how we were lied to about Obamacare and Covid 19?

Scarier than 4 years of not knowing if the president could do anything more difficult than ordering his favorite ice cream?

 
Scarier than the U.S. being last place in first world countries in education despite 108% (inflation adjusted) increase in spending recently--despite we were first before the Dept. of Education was created?

 
Scarier than setting learning back 2 years for all the children in public schools and knowing they have to enter the work world and compete with China with that deficit?

 
Scarier than the huge violations of our rights during the Covid shutdown, including freedom of religion when churches were closed?

 
Scarier than mandatory vaccines and the growing increase in physical harm being revealed especially among the young?

Scarier than millions of illegals flooding our borders and at least 2 million getting social security cards so they can vote?

 
Scarier than Americans thinking USAID was about "aid" and not about agency for international development (aka foreign influence and control)?

Scarier than having Democrats create and use Lawfare to destroy the Republican candidate?

 
Scarier than knowing Democrats set Trump up for assassination because who else hated him that much and were terrified that he would uncover their crimes?

 
Scarier than what's been uncovered by Doge--payoffs to the media, grants frittering away American billions on foolish and dangerous political agendas harmful to our nation?

 
Scarier than a proxy war in Ukraine and a religious war in the Middle East?

Scarier than finding out how unfair the tariff system has been for at least 40 years and Donald Trump has been telling us that the whole time and no one listened?

Scarier than the ugly face of anti-Semitism that we see on Democrat controlled college campuses, especially the elite Ivy League 

Scarier than how the Democrat media yawned at the bombing of Jewish governor Josh Shapiro's home, but are excited about socialists AOC and Bernie fund raising? And how Democrats passed Josh Shapiro over for Tim Walz for vice president?

And I could go on, but that Christian writer needs to dig deeper. The only perfect guy with no faults rose from the dead.

OSU has discovered racism—yet again

For decades, academe has been soaking up tax dollars for special departments, workshops, conferences, vice presidents for diversity and inclusion, and now with more CARES money floating around, plus BLM pulling in billions in literally black mail, the medical college which has been on a socio-economic-race kick for longer than I can remember, is launching yet another effort.  This one I’m sure will include Critical Race Theory, because with that, no solutions are ever developed, the problems are just expanded.  But this one has a cutesy acronym.  It means, shut up and listen to us roar at you.

“This week, the Wexner Medical Center and health science colleges launched a new webinar series, Roundtables On Actions Against Racism (ROAAR). The focus of these roundtables is to elevate critical conversations about racism and engage community leaders to work collaboratively to achieve meaningful and lasting change.”

Are Americans the worst patients in the world?

“Recriminations tend to focus on how Americans pay for health care, and on our hospitals and physicians. Surely if we could just import Singapore’s or Switzerland’s health-care system to our nation, the logic goes, we’d get those countries’ lower costs and better results. Surely, some might add, a program like Medicare for All would help by discouraging high-cost, ineffective treatments.

But lost in these discussions is, well, us. We ought to consider the possibility that if we exported Americans to those other countries, their systems might end up with our costs and outcomes. That although Americans (rightly, in my opinion) love the idea of Medicare for All, they would rebel at its reality. In other words, we need to ask: Could the problem with the American health-care system lie not only with the American system but with American patients?”

Atlantic July 2019. https://www.theatlantic.com/magazine/archive/2019/07/american-health-care-spending/590623/

Anna Loska Meenan, who lives in the Rockford area and used to be on staff at the Mt. Morris clinic, says:

This excellent article explains why Medicare for All in the US would quickly lead to one of two scenarios: Either the health care system would be immediately bankrupted, or the resulting rationing would lead to riots in the streets. Having been involved in health care, I can confirm that this author speaks the truth, and from conversations with docs who are still seeing patients, I can see that things have only gotten worse since I left medicine 10 years ago.

Politics and healthcare

At the coffee shop today I was reading the Oct. 9, JAMA and noticed an editorial on "Politics and Healthcare." JAMA's left of center, but I thought I'd take a look. Praise for Lyndon Johnson and Medicare in 1965, praise for Barack Obama and PPACA (Obamacare) in 2010 and then 3-4 paragraphs lambasting President Trump who, but for McCain, would have been able to undo Obama's disastrous grab of the private sector and 1/5 of the economy. It's one of the reasons Trump was elected--the people hated it, especially those who lost good coverage or lost their doctor or were forced to buy coverage for contraception and abortion. Obamacare was the only significant piece of social legislation that got zero support from Republicans, who had supported FDR and social security, and LBJ and Medicare. In fact, it's doubtful those programs would have passed without Republican support. It is the Obama administration that created the extreme partisanship we see today, not President Trump.

Yes indeed. Politics and healthcare in black and white in JAMA. So I looked up the author, Donald M Berwick--he's retired, but has been on just about every government board and committee to give us socialized medicine, was part of the Clinton administration, and even worked with the British National Health Service and was knighted by the Queen! I would not have expected anything else from him.

My letter to a grant recipient at OSU

Today I noticed in OnCampusToday you’ve received a handsome grant of $2.27 million from NIH for “patient engagement.” Congratulations.  I’ve read through your publications, and you have had an impressive career. Although I don’t know what “concept map to define capacity for engagement” means, I would like to comment on patient portals as a means to engage patients in their own care.

I hate them.

My husband has 2 doctors, 3 if you count the cancer specialist whom he rarely sees, and I have 3, family, ophthalmologist and cardiologist. We share the family doctor. Each practice uses a different portal system for finding our lab results, asking questions, tracking meds, etc.  But the worst feature is their sending us advertisements! I don’t know until I’ve made the effort to get in—not easy—why I’m being contacted. What a mess! Fortunately, I don’t think my ophthalmologist uses one, because he’s the one I see most frequently. When I ask him to send a record to my family doctor, he uses a fax.

Recently we received a notice from our financial advisor suggesting we have our own “portal” for his financial services, and I fired back, Absolutely Not. Face to face is always better. I’ve not had eye-contact with a doctor since Obama imposed the horribly expensive EMR system, which had never been tested for improved care or cost reduction. One of the Emanuel brothers just thought the tech industry needed a pay off. My medical records could be transported faster by carrier pigeons from Riverside Hospital to Dr. Jennifer Bush, 2 miles away. And I hold no hope that patient portals will improve my care, at least not the ones in use by any of our doctors.

And by the way, how secure are these portals? Who designs them to be unworkable? Are they more secure than large medical practice records? Two years ago my husband’s urologist’s practice was hacked, and thousands of records exposed with all the personal data that goes along with that.

I have 9 blogs, I’m on at least 4 e-mail discussion lists, I’m on Facebook, I read a lot of medical, political, technology and religious information web sites, and I’m a retired librarian (veterinary medicine) who formerly taught classes in data base searching and information skills.  I used to teach “older learners,” which is anyone over 25.   You need a system that is easy for 80 year olds or admit this technology does not have the capacity to engage.

Norma J. Bruce

OSU Libraries faculty, retired

March 8--a day without women

Why is the left afraid to investigate the differences in wages among women? For the obvious reasons--we all know the answer. Career choice, education, experience, skill and geography determine salaries in the USA. For men and women.  Both of us use an all female medical practice. I have no idea if they purposely keep out men (except for patients), but there's a high level of estrogen when you walk in. I think I did see a male tech several years ago, but I he's moved on.

And guess what? There is a vast difference in pay among the 

1) female staffer who moves the sliding window, takes our insurance cards and hands us a clipboard, and 
2) the tech who checks our weight, blood pressure and types notes into the computer, and 
3) the doctor who rushes in for 5 minutes and tries to find out what's going on since the last visit.

I'm guessing at income--about $25,000 for the first woman who is a high school graduate, $35,000 for the second who had 6 months of technical school, and about $200,000 for the third woman who had 4 years of undergrad, 4 years of medical school and 3-7 years of residency before I saw her in that office. Where's the rage, and who should be marching on the Day without women? Woman one, two or three?

I asked a pleasant young clerk at the ophthalmologist office what her training was for the field, and she said none, she had a degree (something in the humanities) and this was the job she found when she and her husband moved to the area. Which category will she go in?   That practice is almost all male doctors and female staff.

An insider’s view—sometimes there’s no solution, guest blogger Chris Botkin from Ohio

I work as a laborer in a sandwich packaging plant. I've been there 17 years. The sandwiches go to convenience stores, and vending machines, and institutions like schools and prisons. My little group tapes the boxes of sandwiches shut, separates the boxes by item, stacks the boxes on pallets and records the daily production. It's physical; today we handled about 10 tons of product. There are four of us, three (including yours truly) do the hand-stacking.

It's a different world than many of you inhabit. My coworkers start at $8.50 an hour. Many have felony records, mostly for possession, but some much worse. Turnover is insanely high: the work ethic is not, let's say, universal.

Today, one of my crew had to leave at noon for an emergency doctor appointment he received by phone at about 10:30 am. He has a nightmare of medical conditions I won't go into, the call today was from an oncologist. He tries hard, he has his own business on the side (a bait shop on a nearby lake). He is 25.

Today, another of my crew left an hour and a half early. He is the archtypical good-ole-boy: big, rowdy, randy and without much common sense. Multiple layoffs, multiple arrests, he needs off early once a month (not today) to meet his parole officer. He is trying to turn his life around. We'll see. He's a loose cannon. But he left early today because his mother is in the ICU on life support for advanced pneumonia. He had just received a call from his dad. He looked very upset.

For me, these situations shed a somewhat different light on the health care debate. Without a time machine or assistance, there is no way these folks can pay their medical bills. Hospitals and physicians deserve to be paid. I am highly skeptical that Obamacare is helping, but something has to help.

I'm as old as both these guys' ages combined, and yet I totter along relatively unscathed: all original parts and enough sap to get through the day. I feel it at night, and I need my weekends to recoup, but no complaints. Today made me think about retiring, though. Life's too short. If only I could afford to retire.

I'm posting this  because none of my coworkers will see it, and it reflects at least peripherally on political debate, and it's on my mind tonight. Sometimes, life's just a bitch.

Alabama doctor excoriates EMR damage to patient health care.

Dear Congressman Brooks,

As a practicing family physician, I plead for help against what I can best characterize as Washington's war against doctors.

The medical profession has never before remotely approached today's stress, work hours, wasted costs, decreased efficiency, and declining ability to focus on patient care.

In our community alone, at least 6 doctors have left patient care for administrative positions, to start a concierge practice, or retire altogether.

Doctors are smothered by destructive regulations that add costs, raise our overhead and 'gum up the works,' making patient treatment slower and less efficient, thus forcing doctors to focus on things other than patient care and reduce the number of patients we can help each day.

I spend more time at work than at any time in my 27 years of practice and more of that time is spent on administrative tasks and entering useless data into a computer rather than helping sick patients.

Doctors have been forced by ill-informed bureaucrats to implement electronic medical records ("EMR") that, in our four doctor practice, costs well over $100,000 plus continuing yearly operational costs . . . all of which does not help take care of one patient while driving up the cost of every patient's health care.

Washington's electronic medical records requirement makes our medical practice much slower and less efficient, forcing our doctors to treat fewer patients per day than we did before the EMR mandate.

To make matters worse, Washington forces doctors to demonstrate 'meaningful use' of EMR or risk not being fully paid for the help we give.

In addition to the electronic medical records burden, we face a mandate to use the ICD-10 coding system, a new set of reimbursement diagnosis codes.

The current ICD-9 coding system uses roughly 13,000 codes. The new ICD-10 coding system uses a staggering 70,000 new and completely different codes, thus dramatically slowing doctors down due to the unnecessary complexity and sheer numbers of codes that must be learned.

The cost of this new ICD-10 coding system for our small practice is roughly $80,000, again driving up health care costs without one iota of improvement in health care quality.

Finally, doctors face nonpayment by patients with ObamaCare. These patients may or may not be paying their premiums and we have no way of verifying this. No business can operate with that much uncertainty.

On behalf of the medical profession, I ask that Washington stop the implementation of the ICD-10 coding system, repeal the Affordable Care Act, and replace it with a better law written with the input of real doctors who will actually treat patients covered by it.

America has enjoyed the best health care the world has ever known. That health care is in jeopardy because physicians cannot survive Washington's 'war on doctors' without relief.

Eventually the problems for doctors will become problems for patients, and we are all patients at some point.

Sincerely yours, Dr. Marlin Gill of Decatur, Alabama

Physician reimbursement—or why you’ll wait, by Dr. Anna Meenan (retired at 54)

If you're wondering why your doctor is discouraged and depressed (and many are, though they don't show it) these days, this might help explain it:
http://www.physiciansmoneydigest.com/practice-management/Physician-Reimbursement-Dropped-Sharply
As best I can tell, these are the rates paid by COMMERCIAL insurers. Medicare and Medicaid pay even less than this, and have also been lowering many of their rates. If you think that this is what goes into the doctor's pocket, you are wrong. Out of these sums, the doctor must pay all the overhead of running an office: skilled labor, equipment, supplies, utility bills, and thousands of dollars in malpractice insurance. Think for a moment about what you were charged the last time you called a plumber, or the last time you took your car in for repairs, and put the value of those services up against the value of your life and health. I'm just saying.

$86 for code 99215. Just to clarify, 99215 is the highest code for an office encounter. This is what your doctor would code if you came to his/her office with, oh, let's say, out-of control diabetes with a life-threatening electrolyte imbalance, or if a senior citizen was brought in who was suddenly very confused and not eating. 

Dr. Meenan graduated from the University of Illinois at Chicago, practiced in Rockford and formerly was with the medical clinic in Mt. Morris, Illinois

Access for the underserved (aka poor, minority) to better medical care

I've been looking through the MEDTAPP grant of about $10 million (1.5  years) for seven Ohio medical schools for "underserved" populations.  It reportedly comes from  The Ohio Department of Job and Family Services (ODJFS) which I assume got it from the federal government.  That sounds like a lot of money--except the universities skim about 55-60% for overhead (or did when I worked at OSU).  But imagine how big the amount was before the federal and state governments took their cuts!  Then it is split 7 ways and the money goes first to set up and administer those programs which are primarily for curriculum bloat, training experiences, coordination, outreach, etc. in everything from mental health to pediatrics to gerontology to expansion of faculty. It's no wonder the medical practices and hospitals have low reimbursement for treating the low income sick and elderly.

I couldn’t find within the several websites I checked whether the 1,000 students and trainees who go through these programs have any obligation to actually work with the “underserved.”

Government programs provide a very fine living for “public servants.”  No one in this pass through of funding is poor, underserved, mentally ill, elderly, or low income. Let’s hope something at the end of the line helps the needy (aka underserved).

• The University of Akron – College of Nursing
• Case Western Reserve University – School of Dental Medicine and Departments of Family
• Medicine/MetroHealth System, Pediatrics and Psychiatry
• Kent State University – College of Nursing
• The Ohio State University – Colleges of Dentistry and Nursing, Moms2Be Program, Interdisciplinary Behavioral Health Education Program, Interdisciplinary Curriculum Development Program, and Medicaid Practice Placement and Learning Experiences Partnership Program
• University of Toledo – Department of Psychiatry
• Wright State University – Division of Child and Adolescent Psychiatry and the Community Psychiatry Collaborative (involving the Departments of Psychiatry, Geriatrics, Community Health and Family Medicine).

https://ckm.osu.edu/sitetool/sites/grc2public/documents/11MEDTAPPHAIOVERVIEW.pdf

http://grc.osu.edu/medicaidpartnerships/healthcareaccess/

http://nursing.osu.edu/news/news-headline-articles/Ohio-Medicaid-to-Fund-Statewide-Projects-to-Train-More-Than-1000-Health-Professionals.html

If you hate Cheney's, let's talk about Clinton's heart instead

Michelle Malkin writes:

Two years ago this month, as public debate over Obamacare raged, former President Bill Clinton rushed to the hospital because of a heart condition. He immediately underwent a procedure to place two stents in one of his coronary arteries. It was a timely reminder about the dangers of stifling private-sector medical innovation. No one listened.

Stents don’t grow on trees. They were not created, developed, marketed or sold by government bureaucrats and lawmakers. One of the nation’s top stent manufacturers, Boston Scientific, warned at the time that Obamacare’s punitive medical device tax would lead to worker losses and research cuts. The 2.3 percent excise tax, the company said, “would be very damaging to Boston Scientific, and the medical device industry as a whole. In a nutshell, it would raise costs and lead to significant job losses. It does not address the quality of care but the political scorecard of savings.”

Read the whole article, Taxing medical progress to death.

Healthcare Costlier All Around for Afib Patients - in Clinical Context, Strokes from MedPage Today

I had no idea that A-fib was so expensive! Atrial fibrillation patients are generally sicker than those who don't have atrial fibrillation which apparently accounts for the higher costs. According to this article

Treating patients with atrial fibrillation costs the U.S. an estimated $26 billion more per year than treating patients who don't have the condition, researchers reported after extrapolating 2008 data for 2010.

Total direct medical costs were estimated to be 73% higher in atrial fibrillation patients than in matched control subjects, representing a net incremental cost of $8,705 per patient per year, according to Michael H. Kim, MD, from Northwestern University in Chicago, and colleagues.

The estimated annual cost included $6 billion related directly to atrial fibrillation, $9.9 billion for cardiovascular risk factors or disease, and $10.1 billion for noncardiovascular medical problems, according to the study published online in Circulation: Cardiovascular Quality and Outcomes.

Medical News: Healthcare Costlier All Around for Afib Patients - in Clinical Context, Strokes from MedPage Today

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

Staples on a dollar and a head

I was looking for information on whether it is legal to staple a $20 bill to a letter and came across a story from Florida where a woman took her 8 year old to an ER for a small head wound caused by a pillow fight, and left with one staple over the wound and a bill for $1,654, of which $754 was covered by the family's insurance. Both the article and the readers' comments are mostly filled with the outrage over the cost of medical care for such a small accident. Duh! I wonder why?

It appears that few read it, or know anything about insurance, medical care or the costs of doing business--any business. Isn't it odd that other workers seem to want to be paid for their labor, to get their benefits paid by their employer, to receive unemployment and worker's comp, but doctors, nurses, lab techs, schedulers, and janitors in clinics should work for nothing or minimum wage? Isn't it strange that your landlord, electric company, gas and water utilities, gardeners, and street pavers all need to be paid and factored into your business costs, but not hospitals (she took him to the ER) or "doc in a box" clinics. And I found it odd that most people can grasp, when they get the bill, what 4 years of college costs, but are in la-la land about tacking on another 4-8 years of medical school to those costs. It appears from the article that no further testing was done to pad the costs (regardless of what Obama says about wrong foot amputation), so we can assume the doctor recognized from his training that a superficial head wound would bleed--a lot.

That ER where Mrs. Tobio took her child is also treating people who have no regular doctor, no insurance and no intention of ever paying. By law, it has to treat them too. So that cost is picked up by the people who do have insurance. And the doctor that stapled the wound has to carry malpractice insurance so that's factored into his costs--and no tort reform will be included in the current Senate or House bill because the lawyers have a powerful lobby. Also, in order to save costs, and they've already saved a bundle, the Tobios carry a very high deductible policy--$2500--choosing instead to cover the out of pocket expenses and pocket the savings. Some years they win, and some they don't. Even a few months of savings covered that $900 they had to pay. And their state regulates who they can buy from so that reduces competition and increases cost. That too isn't addressed in the current "reform."

When I was a kid, I was jumping on a bed like a trampoline and hit the ceiling cracking my head open. I don't remember if Mom took me to Dr. Dumont or not--there were puddles of blood everywhere so she probably did. Head wounds bleed like crazy. He probably used a needle and thread. I still have a bump and it's covered by my hair. But parents would not settle for that today. Childhood bumps have to have first class, non-scarring treatment. And no one had health insurance.

The reporter did her job--she got the scoop on what the real costs are behind that little staple in Ben Tobios head, but that's at the end. Most readers commenting, never got that far.

His staple paid for all the things the hospital does not, or cannot under current laws that regulate government programs such as Medicare, charge for, Sullivan said: bed sheets, plastic medical tubing, privacy drapes.

"Staples may be something we can charge for, so those things end up with what looks like a very high charge based on what the cost is," Sullivan said.

"At the same time," he added, "what drives the cost of health care is people get in a facility and they want the best doctors, the nice MRI machine that costs $1.5 million; they want the best of everything because we have very high expectations in a time of need, and there is a cost to that."

If I make coffee at home, it costs about ten cents a cup; if I go to Panera's it's about $1.80 plus my driving costs which includes auto insurance.