Words matter, less is more

 The Lord's Prayer has 56 words.

Gettysburg Address has 268 words.

The Declaration of Independence has 1458

The U.S. Constitution has 4,543 words, including the signatures, unamended

Right to Try Act (2018) 5 pages

Report from the National School Board Association's investigation about its letter to Biden suggesting parents could be terrorists is 55 pages.

American Recovery and Reinvestment Act (ARRA ) of 2009 is 407 pages.

Affordable Care Act (Obamacare) was 2,700 pages at time of pages, not including 20,000 pages of regulations (this number is debated) which followed.

I can't find the number of pages in the "American Families Plan," which is a subset of pages/words of Build Back Better, but it's $1.8 trillion for starters.  

Preparing for surgery tomorrow

[This is what I wrote in an e-mail, but I'm just leaving it here in case you're researching what to do.]

My head explodes when I think what we pay for these EMR!! How many billions ($27 billion in 2009) and there wasn’t a shred of evidence from any studies it would help health care.

 

We just had a call from the hospital (9 a.m. Tuesday) from a clerk checking all the details for surgery tomorrow. We have to call between 2-4 p.m. today to find the hour of the surgery on Wednesday. The hospital still didn’t have any of the test results from his complete physical on Aug. 16—different doctor, 2 miles down the road. Carrier pigeon could have done it better. And as I think I mentioned before, his internist never received the results of the scans 3 weeks before his physical. Also the hospital had him listed as 5’11”, high blood pressure and cataract surgery. None of that is true. I’m wondering what other Bruce’s medical records got folded into his. He’s about 5’8”, no problem with blood pressure ever, and his eyes are fine. Always, always, have another person checking. The lobbyists for IT made a bundle on this, but at our expense. 

 

Rant over. I’m going to vacuum to blow off steam.

 

http://www.prnewswire.com/news-releases/report-electronic-medical-records-market-nears-25-billion-300066515.html

 

http://www.hitechanswers.net/about/about-arra/

 

As a bonus, here’s what I wrote about this problem 7 years ago:

 

I stopped by to pick up a prescription at my doctor’s office because the “electronic transfer” of information between that office and the pharmacy I used hadn’t been able to manage the job in 3.5 days, and I was out (old methods of fax and phone aren't used anymore). Normally, I would have just told the receptionist what I needed, and my file (paper) would have been retrieved (human). No. I waited about 10 minutes as she struggled getting the right screens up, then worked from screen to screen, asking me questions I didn’t know, like date of my last appointment and address of the pharmacy. A line was forming behind me. When she finally found it, she said there was no record from the pharmacy requesting permission for a refill, but the doctor would decide.

That night we got a call from the doctor’s office that “it was ready,” i.e. the prescription script. My husband went to pick it up and waited about 15 minutes in line as the receptionist struggled with the screens of 2 or 3 people ahead of him. Fortunately, it was in a paper envelope with my name hand written on the outside. We can only hope and pray that the national “network” that Obama is forcing thousands of small offices to buy into (causing many to close their doors), doesn’t work any worse than what you’ve all experienced at the local level as your doctor or clinic transitions.

Maybe Baltimore should return the money

I got an e-mail from the NAACP today on the Baltimore anniversary, maligning the female Democrat Mayor and city government and minority control of that city. Whuddathunkit! Baltimore received over a billion, $1,831,768,487, though the American Recovery and Reinvestment Act (ARRA) in a Democrat controlled Congress with a Democrat black president. Not that they ever mention the party in power.

 "The unrest of Baltimore on April 27, 2015 shocked many people, in Baltimore city and across the country, into confronting the history of segregation, racism, and indifference of the past, and its role in mass unemployment, crime, poverty and neglect that remain today." 

Still think Bernie or Hillary have the answers with socialism?  If all that federal assistance can't fix any of these problems, I guess Baltimore is just going to have to elect a better government.

The Great Recession was made great by President Obama

The last recession was over (according to the way the federal government figures these things) in June 2009, before any of Obama's ARRA programs hit the pavement and wallets of unions and government workers. And today he's taking credit for turning around the longest "Great Recession" in our country's history, and proud that unemployment is at 4.9%. Could be, but homelessness in Columbus is at an all time high, as is SNAP participation, and labor force participation is lower than in the 1970s, and people are scrambling to pay for health insurance. He even takes credit for the slowing increase in health care costs, even though that had been going on for 4 years before he took office, and is now on the way back up. The turn around we do have is because Republican governors pulled it out for their states with rebuilding small business and finding new sources of energy. The absurd length of this last recession's fits and starts economic "come back" can be laid right at his socialism feet. The only president who took longer was FDR.

What Americans really think about the recovery

According to a Pew Report on what the American public believes has happened in the economy, “72% say that, in general, the government’s policies since the recession have done little or nothing to help middle class people, and nearly as many say they have provided little or no help for small businesses (68%) and the poor (65%). These opinions have changed little in recent years, and differ only modestly across demographic and income categories. There are significant partisan differences in these views, though majorities of Democrats, Republicans and independents say that government policies following the start of the recession have done little or nothing for the poor and the middle class. Similarly, more think household incomes have recovered than did so two years ago. But while 51% say there has been a partial recovery in incomes (up from 42% in September 2013), just 4% say they have fully recovered. About four-in-ten 42% think household incomes have hardly come back from the recession.”

Many believe that banks, corporations, the wealthy have benefited from government policies since the “Great Recession.”  I personally think politicians have said very little about the poor in recent years, and increasingly emphasize the middle class not making progress.  And if they do move ahead, then they complain about a gap.

“The analysis in this report is based on telephone interviews conducted February 18-22, 2015 among a national sample of 1,504 adults, 18 years of age or older, living in all 50 U.S. states and the District of Columbia (526 respondents were interviewed on a landline telephone, and 978 were interviewed on a cell phone, including 559 who had no landline telephone).”

Why we don’t make a dent in the hunger problem

We never see improvement and the rolls of both poverty workers and the needy continue to grow. Hunger became "food insecurity" and poverty is an arbitrary number set by the Government that is raised every year, but “percent of poverty level” is the standard for benefits. 200% of poverty is the standard for food assistance in Ohio. To be "food insecure" means at some time during the year you changed your eating pattern to accommodate your resources.

The actual number of Americans who are “food insecure” for more than a few days is tiny, under 1% and most of those are children in unmarried households and elderly without family, but even a day counts toward the annual figure--the figure we see in the news is 14.3%.  This guarantees political fights in Congress when USDA funding comes up, government grants to academics, fodder for campaigning, and good jobs for people and agencies in the benefits distribution field. Churches, charities, non-profits and foundations also receive a portion of their annual budget from government grants. Food pantries, mostly run by churches, are involved in a complex mix of federal, state, local and non-profit resources.

62% of "food insecure" families participate in SNAP, WIC or free and reduced school meals (we used to call this school lunch, but now it is breakfast, lunch, and after school, plus summer meals).

Poverty rolls took a big jump in 2008, but haven't really come down.  A chunk of ARRA money in 2009 went to find and enroll people in the programs. It was very successful. Because of the weak economy, they remain on the rolls.

If poverty were solved tomorrow, we’d have a whole new crew of poor people—those who formerly worked in the business.

http://www.ers.usda.gov/media/1565415/err173.pdf

The Ohio Association of Foodbanks was awarded $2.18 Million Federal Navigator Grant for a 2nd year not to feed the hungry, but to enroll people in Obamacare.

The Ohio Association of Foodbanks is Ohio’s largest charitable response to hunger, representing Ohio’s 12 Feeding America foodbanks and 3,300 member charities including food pantries, soup kitchens and shelters. In SFY 2014, the association and its member foodbanks were able to acquire and distribute over 186 million pounds of food and grocery items. The association also serves as the home of The Ohio Benefit Bank and operates the state’s largest navigator program for the Affordable Care Act.

http://admin.ohiofoodbanks.org/uploads/news/Press_Statement-_Federal_Navigator_Grant_Awarded5.pdf

Remember this boondoggle—Cash for clunkers

Cash for clunkers" (part of Obama's 2009 stimulus) actually cost the auto industry 3 billion in less than a year, according to recent research. I wonder why no one ever calculates the cost to low income families, who if they could buy a c...ar, any car which was destroyed by this program, could get to work, the super market, family reunions, recreation, etc.? And how many moderate income family took on new debt to buy that environmentally friendly vehicle due to the carrot of a discount? It's about more than the auto industry losses. http://www.nber.org/papers/w20349

“Cash for Clunkers was a 2009 economic stimulus program aimed at increasing new vehicle spending by subsidizing the replacement of older vehicles. Using a regression discontinuity design, we show the increase in sales during the two month program was completely offset during the following seven to nine months, consistent with previous research. However, we also find the program's fuel efficiency restrictions induced households to purchase more fuel efficient but less expensive vehicles, thereby reducing industry revenues by three billion dollars over the entire nine to eleven month period. This highlights the conflict between the stimulus and environmental objectives of the policy. “

Not Obama’s standard

This should be Obama's standard for SNAP--not how many people he has added, but how many don't need it anymore.

During the last five years, the SNAP program grew by 36.8%, from $58,223,790,000 in 2009 to $79,641,880,000 in 2013. http://cnsnews.com/news/article/ali-meyer/record-20-households-food-stamps-2013#sthash.rIiq4riE.dpuf

However, the number on food stamps decreased in 2012 and 2013 as the economy improved, despite the recruitment for more participants.

In the U.S., hunger is on the list of missing, politically incorrect words; it is “food insecurity,” a much more plastic, pliable term, and it only has to occur very briefly to be included in the stats.

According to USDA Economic Research Service 11.1 percent of all US households were food insecure during some period during 2006. That percentage of food insecure households increased to 14.5 in 2010.

 

Notice the huge jump in costs in 2009—ARRA money was used to recruit more users. By government think, this “infused” money quickly into the economy, but I suspect most went to hire additional workers rather than provide improved nutrition.

From 2007 to 2010, the number of families below 125% of the federal poverty level increased by 16% (because of the recession). That's a lot of people--mostly children without fathers in the home. However, the number of households receiving SNAP benefits increased by 58%. This means that the SNAP recipiency ratio, or the ratio of households receiving SNAP to that below 125% of the poverty line rose by 37%. "The Redistribution Recession," by Casey Mulligan

Urban Institute, a progressive think tank, believes SNAP helps the poor and the economy, as does all the government reports. After all, it is a USDA program. Here’s their take. http://www.urban.org/UploadedPDF/412613-SNAPs-Role-in-the-Great-Recession-and-Beyond.pdf

It began with ARRA, which we were told was a “stimulus.”

Although today Jan. 1, 2014, is the starting date for the insurance, Obamacare actually started in 2009 with $19 billion in the ARRA stimulus. It didn't stimulate anything except the bottom line of electronic medical records companies. There is no research showing EMR will save money or improve health. We have it as a result of a huge lobbying effort. You've seen how even private companies (like Target) struggle with stolen records, even my research information at OSU was compromised--just wait until your medical information is stolen from a national database. In my recent stay in a local hospital, the EMR couldn't even make it 2 miles down the road to my doctor's office. http://www.anh-usa.org/your-medical-records-are-part-of-a-19-billion-experiment/

And despite these billions of dollars and the perceived benefits of EHRs, physicians continue to hesitate in implementing fully functional electronic health record (EHR) systems. Even with incentives, systems are expensive and productivity hits are a major concern, but the major cause? Unlike other highly specialized, specifically tailored health information technology solutions, EHRs are awkwardly, poorly designed to be one-size-fits-all—and studies show they never do. The incentive program is slowly drawing eligible healthcare practitioners into the EHR fold, but the lack of specifically tailored EHR systems means that the U.S. will continue to lag the rest of the world when it comes to establishing a fully integrated, cost-effective health care system.

http://www.talkchart.com/blog/index.php/why-is-ehr-adoption-lagging-behind/

Information such as social security numbers, addresses, medical insurance numbers, past illnesses, and sometimes credit card numbers, can help criminals commit several types of fraud. These may include: making payments from stolen credit card numbers and ordering and reselling medical equipment by using stolen medical insurance numbers.

A key finding from the report is that fraud resulting from exposure of health data has risen from 3% in 2008 to 7% in 2009, a 112% increase.

http://www.informationweek.com/security/risk-management/emr-data-theft-booming/d/d-id/1087881?

http://www.nejm.org/doi/full/10.1056/NEJMsr1110507

ARRA and Homelessness

“Under Title XII of the American Recovery and Reinvestment Act of 2009, the U.S. Department of Housing and Urban Development (HUD) is allocating $1.5 billion for communities to provide financial assistance and services to either prevent individuals and families from becoming homeless or help those who are experiencing homelessness to be quickly re-housed and stabilized.” copied from the Franklin Co. Ohio web site.

I checked Hamilton Co. (Cincinnati) and Montgomery County (Dayton area) and found something similar.  In order to get these funds, substantial changes needed to be made to programs already in place.

I wonder what became of the $1.5 billion? I was able to locate the third year report for Springfield, Ohio, which received about $816,000, but there were so many lines of requested information with “no information,” I really couldn’t read it. In the reporting year ending 2012, 42 people were served, 21 households.  Near the end, the compiler said Springfield already had a good program that was working when it received the money.

Like many grants in ARRA it was late getting out of the gate (the recession was technically over) or didn’t do anything about the economy.  A huge chunk of ARRA  ($19 billion) went for Electronic Medical Records assistance to force doctors into a system that was untried and had never been proven to save money.

NCLB and RTTT—a comparison

Confused about how the Department of Education spreads around your tax dollar? Here's a comparison of No Child Left Behind (Bush, 2001, regular budget funding, Title I) and Race to the Top (Obama, 2009, ARRA money through grants, on top of NCLB). Bush's is a mandate; Obama's is more money for improvement—competition. Sort of a flip flop of how the right and left say they do things.

Until Obama came on the scene, Bush was the biggest all time spender on social programs; but that didn't get him any points with Democrats.

http://www.cga.ct.gov/2010/rpt/2010-R-0235.htm

The cost of the stimulus

"Last week, President Barack Obama refused to allow private citizens to spend $7 billion improving America's energy infrastructure. Three years ago, he insisted that taxpayers spend more than 100 times that amount on an outlay that also addressed the nation's energy needs, among other goals. But while the Keystone XL pipeline that Mr. Obama rejected was certain to deliver a product that people want, the benefits of the president's 2009 stimulus program are harder to discern.

Sold as a way to create jobs while building infrastructure and an environmentally sensitive economy, the stimulus plan was drafted in haste by Democrats in Congress and then signed by Mr. Obama on Feb. 17, 2009. The American Recovery and Reinvestment Act was priced at $787 billion when enacted; the official estimate is now more than $800 billion."

From the WSJ book review of "Money Well Spent?"

How we got HITECH folded into the Stimulus Bill

Abstract from New England Journal of Medicine, Dec. 15, 2011, "Wiring the Health System--Origins and Provisions of a new federal Program, pt. 1, David Blumental, MD

In February 2009, the U.S. government launched an unprecedented effort to reengineer the way the country collects, stores, and uses health information. This effort was embodied in the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of a much larger piece of legislation, the so-called stimulus bill. The purpose of the stimulus bill, also known as the American Recovery and Reinvestment Act of 2009 (ARRA), was to stimulate the economy and prevent one of the worst economic recessions in modern history from becoming a full-fledged depression. Congress and the Obama administration took advantage of the crisis to enact programs that might spur short-term economic growth as well as promote scientific and technical advances with potential long-term benefits for the American people. In the health field, one such program involved a commitment to digitizing the U.S. health information system. The HITECH Act set aside up to $29 billion over 10 years to support the adoption and “meaningful use” of electronic health records (EHRs) (i.e., use intended to improve health and health care) and other types of health information technology.

According to the article, which goes on for pages and has voluminous footnotes, there were only TWO arguments in favor of this program:

1) the conviction (i.e., no facts, no data, no research) that information technology could improve health and health care
2) a need for the government to remedy the perceived but unproven problems inhibiting the spread of health information technology

Looking further for statistics on why this was needed, I found in Blumenthal's puff piece a number of additional arguments for HITECH based on nothing more than intuition, lack of statistics, and a hunger of government officials for more or more.

3) it was “intuitive.” How’s that for hard evidence?
4) the lack of what they wanted--only 17% of physicians and 12% of hospitals had fully functioning electronic health records. (Wow! what a bonanza for the IT industry and its lobbyists!)
5) We already had the most expensive system without IT, and Europe had health IT, so if we heaped this cost on top of that, we could have a “fundamental technological breakthrough.”
6) It would be a benefit to “policy makers” (that means DC law makers) and
7) the “implied” need could improve care if information were shared, and paper records are difficult to share.
8) There was some empirical evidence from the Veterans Administration System and the Kaiser Permanent Health Plan (a tiny puddle in the overall sea of health records) for treating chronic illnesses.
9) The National Institutes of Health (a government agency) wanted it.

Just as the reasons HITECH was necessary to rush through in the stimulus bill in 2009 (to help the economy) were as fragile as a butterfly's wings and its movement of air, so the reasons not to do it were much more substantial.

1) economic--no reward for improved efficiency in medicine--except to patients and insurers--which in government talk means the markets have failed.
2) logistical and technical--it is so complex, that obviously the government needs to step in to help overcome this barrier.
3) the ability to do this is "underdeveloped," so therefore this huge challenge requires something even more huge--the federal government
4) privacy and security of records--no solution is even offered for this one except noting the health record industry is not currently regulated, so you know where they're going with that one.
Wiring the Health System — Origins and Provisions of a New Federal Program
Clever terms only a doctor on the government payroll (Blumenthal was national coordinator) could use:

• "meaningful use" of electronic health records
  
• meaningful use was a new idea with no precedent in law, policy, or the health care literature
  
• multiple major new regulations with far-reaching impact with a short deadline
  
• new programs had to be created from whole cloth (his exact words, folks!)
  
• targeted public investments
  
• encourage millions of health professionals and institutions to adopt and use
  
• justified intervention
  
• create the need for government remedies
  
• intuitive rationale
  
• experts agreed
  
• policy makers need
  
• bunches of vague statistics about quality, doctors, sharing information
  making available $27 billion
  
• federal government is correcting market failures
  
• EHR can create huge databases for local, national and international research
  
• If left to their own choices/devices providers would "never use them efficiently"
  
• Congress incentivized, with secretary of HHS allowed to define "meaningful use"
  create an opportunity
  
• the gov't dept charged with all the regulations for HITECH had never drafted a regulation or run a technical assistance or training program and had only 35 employees, so obviously the first job creation of ARRA was to add government staff!

This is only pt. 1, and I think Blumenthal has no idea he has made this sound like the Katzenjammer Kids on Parade. I can hardly wait for pt. 2.

One job, created or saved--$800,000

I was browsing the government ARRA "transparency" site for the first stimulus (looked like it had been months since it was updated), and I came across a place in Georgia, Huston County, I believe, where upgrades to a public housing project TJ Calhoun was to get $800,000. Under jobs created or saved category, the word "one." But nothing had been done, so I guess that's a moot point. Meanwhile, on the radio, I can hear the familiar voice castigating Republicans for wanting people to stay unemployed. ARRA money went to unions and to government agencies. ARRA Junior won't be any different.

How did purchasing this van help the economy?

I noticed a white van parked at the hotel this morning. There are several high school sports teams in town for sports camps--we see them running past our cottage with their coach on a bike. I suppose this was their transporation. Just curious how this van helped either the town or the state since federal stimulus funds were used to purchase it. I looked up Louisville, Ohio + ARRA and discovered it received about $330,000 to fix an intersection. Didn't see anything about purchasing vehicles for the schools.

The Myth of Green Energy Jobs: The European Experience

We have very clever capitalists in this country. They know where the money is and right now the green is in the green. The myth of green energy. Coupled with the same old government playas (using our tax money), we're off to the green races. Don't believe the climate scare stories or save dear Mother earth stuff--that's just window dressing. This is about who controls the next money scam. Every architectural/engineering publication that comes to our house is loaded with a tsunami of green advertising and government handouts against which the building trades are helpless--they can't get any other kind of work.

With $2.3 billion in Recovery Act tax credits allocated for green manufacturers, President Barack Obama and other Democratic politicians have high hopes for green technology. But their expectations clash with both economic theory and practical experience in Europe. Green programs in Spain destroyed 2.2 jobs for every green job created, while the capital needed for one green job in Italy could create almost five jobs in the general economy. Wind and solar power have raised household energy prices by 7.5 percent in Germany, and Denmark has the highest electricity prices in the European Union. Central planners in the United States trying to promote green industry will fare no better at creating jobs or stimulating the economy.

AEI - The Myth of Green Energy Jobs: The European Experience

Governor-elect Scott Walker, Wisconsin

"Wisconsin Gov.-elect Scott Walker urged the federal government Tuesday to give up on high-speed rail and instead use the money to repair roads and bridges he said were "literally crumbling." "

I thought Obama promised ARRA funding would repair our crumbling infrastructure--it was supposed to be shovel ready funds, right? What happened? I saw a lot of torn up roads and streets in Ohio with those bright orange ARRA signs. In fact, it looked as though ARRA street repair was going to ruin every business in downtown Bucyrus!

I didn't know Wisconsin had elected a Republican--but he's strongly pro-life and small government, he's against rail boondoggles and embryonic stem cell research, so I guess that's what they've done.

Maybe he can answer my question

Today I wrote to Patrick P. O'Carroll, Jr., Inspector General of the Social Security Administration. In September he wrote (or his staff did) a report on the dead people and convicts who received the $250 stimulus check back in 2009. 71,688 beneficiaries were deceased and received about $18 million and 17,348 beneficiaries were incarcerated and received $4.3 million. I always wondered why I received one because people with teacher's pensions aren't allowed to "double dip" so I don't get a Social Security check. If there's going to be a clawback, I don't want to wait until they've added a few hundred in interest. I won't hold my breath to see if he answers.

The Hype of ARRA: shovel ready jobs created and saved

Now that even the President as admitted (New York Times) that there never were "shovel ready" projects, the hype and tripe we were fed the past 2 years sound even worse. Plus the subtle message is that the government was doing nothing before Obama descended from the lofty heights of white guilt to save us, despite the fact that President Bush was the biggest spender on social programs in all the history of the U.S., only to be outdone by the raging trillion dollar deficits of Obama!

The American Recovery and Reinvestment Act of 2009 (Recovery Act) was signed into law by President Obama on February 17th, 2009. It is an unprecedented effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century. The Act is an extraordinary response to a crisis unlike any since the Great Depression, and includes measures to modernize our nation's infrastructure, enhance energy independence, expand educational opportunities, preserve and improve affordable health care, provide tax relief, and protect those in greatest need."

If there were challenges "long neglected" then where was Congress--controlled by the Democrats for most of my voting years? Jobs have not been created or saved, and if you laid the graph of our economic ups and downs since 2008 on top of one from the 1930s, you'd see Obama is following FDR's failed template.

The above quote came from the National Eye Institute where I was researching the number of Americans at risk for glaucoma over the age of 40. When I tried to check on how much of ARRA for the NIH (over $10 billion) has been spent, I found "spin doctors" from left wing think tanks and golly gee-whiz writers for government agencies all saying the same thing about saved or created.

Look folks, the health research industry (mainly universities) lives on government grants--this was a huge infusion for NIH, but I seriously doubt hiring a temp researcher or newly minted doctor on a project started 5-10 years ago really "created" anything. The time and effort to solicit and process the grant proposals, plus the special quasi-government companies that sprang up to do all this probably ate up 50% of it. All these jobs are temporary--a bit more glamorous than FDR's CCC camps of the 1930s, but from them we at least got some parks and roads.

White House claims it met stimulus goal of 70% spent by Sept. 30

But no one knows how, unless they really goosed it that last month, because they weren't even close. For now, "if they said, it happend" is the rule of this administration. Here's one agency that didn't get its spent--Department of Homeland Security, one that you would think (if you thought like a conservative) would have no problem.

"•The Department of Homeland Security has spent less than $500 million of its $2.8 billion allocation. When the stimulus bill was passed, the CBO estimated that Homeland Security would spend more than $1 billion by now. The slow spending comes from nearly every part of the agency. For example, Customs and Border Protection has paid out less than $50 million, even though it was authorized to spend $680 million to modernize ports of entry and deploy other border technology. That program was halted briefly last fall as news media and members of Congress questioned the plan to modernize little-used border stations in Montana and North Dakota instead of busy crossings along the southwest border." Link

So some alert news media noticed the ND stations weren't as big a risk as Arizona and NM. Who knew!