Thursday, September 17, 2009

Health Insurance Reform, the USA needs to recapture the health of its citizens.

One other thing I found fascinating. I received a new Lincoln penny the other day in some change from a purchase. I didn't know there was a new penny minted. It is really very nice. I love it. Love the artwork, too. I put it aside until I at least get another one.

Remember what Bush did when he got into office? With the currency. He wanted to melt down pennies and forget there was ever a denomination that small and he minted all these dollar bills with colors and gold leaf on them.

Pennies are important again. I like it. I like it a lot. It matches the color of the print I indicate are 'my words' to distinguish from newsprint. Yep. I have a small incomplete collection of 'Wheat Pennies.' Yep. Buffalo head nickels, too. I have nearly a complete set of them. Yep.

Honest Abe.



President Barak Obama is NOT a politician before he is this country's President. This speech took place in Texas where the Governor plays the electorate for fools in declaring he wants to secede from the nation.

This speech was in Texas where impoverishment of 'humanitarian values' is held near and dear to their hearts as a means to fight socialism.

Would Georgie Bush or Dickie Cheney ever take the chance of being booed at a rally of Democrats in Fint, Michigan? No. Their public appearances were insulated and orchestrated.

Hello? Our President is a real President. Hard to recognize I know since its been so long since we had one.



He went to Texas to initiate 'outreach.' He is a "Politician without Borders." I didn't see Governor 'what's his name,' oh, yeah, Perry there either.



From the New York Times (click here)

Cost of health insurance rising faster than pay (click here)
Associated Press
10:02 a.m. CDT, September 17, 2009

WASHINGTON - A national advocacy group says health insurance premiums rose five times faster than earnings in Illinois from 2000 to 2009.
The report released Thursday says, on average, the annual insurance premium for a family paid by employers and workers rose from $7,220 to $13,397. That's an increase of nearly 86 percent.
The workers' portion rose at an even steeper pace.
Meanwhile, the median earnings of Illinois workers rose just 17 percent, from $26,806 to $31,414.
The report comes from Families USA, a group working to expand health care coverage. The group based its findings on federal data.
Congress is considering several bills that aim to restrain costs. But benefits consultants have said if any reform is passed this year, it won't have a major effect for a few years.

Let's do some reading. I think I left off with Page 600 or something close to that. It was the penalities to institutions that dragged their feet and broke the rules. That went on for awhile. Let's see.

Here is the paragraph that speaks to the closing of facilities:

Page 601, a word at the end of 14 to line 24:

...and some portion of such funds may be used to support activities that benefit residents, including assistance to support and protect residents of a facility that closes (voluntarily or involuntarily) or is decertified (including offsetting costs of relocating residents to home and community based settings or another facility), projects that support resident and family councils and other consumer involvement in assuring quality care in facilities,...

The Secretary intends to collect the money, too. They ain't messin' around. Well, they can't. People's quality of life and well being are on the line. You know?

Page 603, lines 15 through 25:

‘‘(IV) COLLECTION OF CIVIL MONEY PENALTIES.—In the case of a civil money penalty imposed under this clause, the Secretary— ‘‘(aa) subject to item (bb), shall, not later than 30 days after the date of imposition of the penalty, provide the opportunity for the facility to participate in an independent informal dispute resolution process...

Page 607, lines 6 through 14:

(1) IN GENERAL.—The Secretary, in consultation with the Inspector General of the Department
of Health and Human Services, shall establish a pilot program (in this section referred to as the ‘‘pilot program’’) to develop, test, and implement use of an independent monitor to oversee interstate and large intrastate chains of skilled nursing facilities and nursing facilities.

This is an important provision and I am going to tell you a true story as to why this is important. It might not seem like a true story, but, it is. Has nothing to do with HIV/AIDS either.

There is a chain of nursing homes in this country that specializes in 'ventilator dependant' patients. Patients on vents are sometimes quadraplegics and need continuous monitoring. If a family is unable to care for them at home, the patients are placed in one of these nursing homes. The nursing home itself is very different than an ordinary facility. They have operating rooms where 'procedures' are performed and an emergency room that doesn't really accept patients for treatment, except for an occassion drunk that wanders in. The reason this chain has these 'extra' facilities is because it ranks them as an acute care facility and they are able to charge more for their services. They really are 'faux' hospitals, but, are sincerely 'dumping grounds' for nursing home patients no one else wants to accept.

There was a 19 year old man involved in a car accident where he was a passenger. He suffered a spinal cord injury that made him a quadreplegic.

Nice guy.

When he made it to the hospital emergency room, Level 1 Trauma Center, his cognition was intact. His cognition remained intact during his stay in the Intensive Care Units. He was stabilized. There came a time when there wasn't anything else the hospital could do for him and he needed to go home. His parents, people like you and me that would be grateful to have him alive, were unable to care for him. So, it was decided he would have to be placed in a nursing facility that would provide care to vent dependent patients.

About three days after his discharge, he was readmitted to the same exact Intensive Care Unit that sent him to the nursing facility. This time, however, he was without the cognition he left with. He had suffered an anoxic event. The event was so prolonged that he had a heart attack as well. There was significant damage to his body systems and he died approximately two weeks later in kidney failure as well as myocardial damage.

The nursing home facility had 'on staff' nurses certified in ACLS. As a matter of fact, all their nurses are certified in ACLS. One would think a person on a vent would be in the best of care in such a facility. However. That is not the case. The reason the nurses needed to be Certified in Advanced Cardiac Life Support is because there were frequent events where patients, including quads (sometimes in halo traction) unable to help themselves, would come off their vent. They would cough and sometimes plug their trachea tubes. They would have their vent tubing come off their trachea tubes. So, the anoxic events were an issue in this facility and the administrators had to come up with a way to 'MAKE THEM ALIVE' in case they died while 'on a ward' or in a 'multi-bed' room.



You see, vent alarms go off so frequently and there is less staff then necessary to maximize profits, that the nurses can't keep up with the care and if they simply run around putting out vent alarms they never get any of their medications passed or documentation done.

So, every once in awhile, when a patient is left on an alarm a little to long, they have to 'MAKE THEM ALIVE' even though they died. Hence, many patients with cognitive issues. But, they are cared for, right? I mean someone has to do it. And it is a good business for the economy as it employs folks and all that mess. There are very few visitors after a time.

So, this 'pilot' project is far, far overdue. Yep.

Page 208, lines 4 through 13:

(b) REQUIREMENTS.—The Secretary shall evaluate chains selected to participate in the pilot program based on criteria selected by the Secretary, including where evidence suggests that one or more facilities of the chain are experiencing serious safety and quality of care problems. Such criteria may include the evaluation of a chain that includes one or more facilities participating in the ‘‘Special Focus Facility’’ program (or a successor program) or one or more facilities with a record of repeated serious safety and quality of care deficiencies.

The House really has been working on this bill for some time now. I can tell.

Page 608, lines 14 through 17 and 23 through 25 and Page 609, lines 1 through 3:

(c) RESPONSIBILITIES OF THE INDEPENDENT MONITOR.—An independent monitor that enters into a contract with the Secretary to participate in the conduct of such program shall—...
...(2) undertake sustained oversight of the chain, whether publicly or privately held, to involve the owners of the chain and the principal business partners of such owners in facilitating compliance by facilities of the chain with State and Federal laws and regulations applicable to the facilities;


I guess they didn't want health care insurance reform, now did they?

Page 612, lines 14 through 23:

‘‘(7) NOTIFICATION OF FACILITY CLOSURE.— ‘‘(A) IN GENERAL.—Any individual who is the administrator of a skilled nursing facility must— ‘‘(i) submit to the Secretary, the State long-term care ombudsman, residents of the facility, and the legal representatives of such residents or other responsible parties, written notification of an impending closure—

Page 620, lines 1 through 13:

Subtitle C—Quality Measurements
SEC. 1441. ESTABLISHMENT OF NATIONAL PRIORITIES FOR QUALITY IMPROVEMENT.
Title XI of the Social Security Act, as amended by section 1401(a), is further amended by adding at the end the following new part:
‘‘PART E—QUALITY IMPROVEMENT
‘‘ESTABLISHMENT OF NATIONAL PRIORITIES FOR PERFORMANCE IMPROVEMENT

‘‘SEC. 1191. (a) ESTABLISHMENT OF NATIONAL PRIORITIES BY THE SECRETARY.—The Secretary shall establish and periodically update, not less frequently than triennially, national priorities for performance improvement.

I think it sounds like a good idea.

Page 620, lines 19 through 24 and Page 621, lines 1 through 15:

‘‘(c) CONSIDERATIONS IN SETTING NATIONAL PRIORITIES.—With respect to such priorities, the Secretary shall ensure that priority is given to areas in the delivery of health care services in the United States that—
‘‘(1) contribute to a large burden of disease, including those that address the health care provided to patients with prevalent, high-cost chronic diseases;
‘‘(2) have the greatest potential to decrease morbidity and mortality in this country, including
those that are designed to eliminate harm to patients;
‘‘(3) have the greatest potential for improving the performance, affordability, and patient centeredness of health care, including those due to variations in care;
‘‘(4) address health disparities across groups and areas; and
‘‘(5) have the potential for rapid improvement due to existing evidence, standards of care or other reasons.


It looks self-explanatory. There isn't anything sinister about it.

Page 623, lines 23 through 25 and Page 624, lines 1 through 2 and Page 625, lines 1 through 3:

‘‘(c) DEVELOPMENT OF QUALITY MEASURES.—
‘‘(1) PATIENT-CENTERED AND POPULATION BASED MEASURES.—Quality measures developed under agreements under subsection (a) shall be designed—

‘‘(2) AVAILABILITY OF MEASURES.—The Secretary shall make quality measures developed under this section available to the public.

I'll end there for tonight.

Until later...

The photos of GIs fighting in Vietnam were far more gruesome and bloody than this.

President Obama has promised transparency to his administration and there should not be censorship by the USA military. This isn't the Bush/Cheney years of paranoya anymore. The Associated Press had every right to publish what they felt was appropriate for the context of their news story.

We believe in democracy and have complained of lies in the media, it is hardly appropriate we propagate any lies or deceptions to the American people. Censorship is a form of deception. It is like putting blinders on the public. It is unethical. The American people have a right to know what their military is sacrificing.

I believe in the wars in Pakistan and Afghanistan. I hate the killing more than anyone. But, to allow international criminals access to two countries and one with nuclear potential is unrealistic. If soldiers are to be spared this fate, which they should be, that means there will be more civilian deaths due to more aggressive weapons. The entire war in Afghanistan doesn't make sense to me. Either there is a war to fight and we protect our military from harm or there isn't. This 'mess' of protecting civilians as if they are immune from the battlefield is hideous. If they choose up sides and decide it is more beneficial from a 'warlord' perspective to join the Taliban than they made their choice. The people of Afghanistan either move out of the way of 'shortening and capturing' the battlefield or they don't. But, that is just my opinion.

If the war in Afghanistan is proceeding so poorly, the military needs to weigh the stakes against the outcome. If the American people are going to be disgusted with the photos being published, there needs to be a strategy to success in Afghanistan that will deliver the same outcome.

I don't see a whole lot different between this photo and the flag drapped coffins coming into Dover. One leads to the other.

There were many more issues with Vietnam. The Nixon administration invoked a draft of 19 year olds with a lottery and demonstrators were being killed on college campuses. The dynamics of opposition were different. Today, there were significant deaths for Italy and in that the Prime Minister Silvio Berlusconi called for the withdrawal of their forces. He is also involved in a tough election in Italy as well and it serves his purpose to ask for withdrawal even though it may not occur.


The war in Afghanistan has been allowed to deteriorate by the past administration and deteriorate it has. It is my opinion, it is by far the most dangerous place in the world today and if left to the devices of the Taliban any abandonment by all military forces will result in the return of power to them and a return to neglect of the world only to repeat what has occurred before.

Afghanistan is a disaster area. It is where the Taliban and international terrorists have taken haven from the attacks by The West to end their capacity to strive to destroy civilization as it exists in any country and not just the USA and Europe. As far as I am concerned, there was such gross neglect by the Bush/Cheney administration Afghanistan is a global emergency.

It is not another Vietnam that if left alone will heal its ills. Vietnam had no designs on killing innocent people in far away countries, nor achieving domination of global culture. Afghanistan is different. The consequences are higher.

The Geneva Conventions exist. Yes, they do. But, nowhere in those accords does it state civilized nations have to sacrifice their military or accept defeat for the sake of civilians in a country that has been allowed to become the enemy to the world. Charlie Wilson's War didn't fail because the USA did not send money for infrastructure improvements. Charlie's war was a defeat because he facilitated 'the base' of al Qaeda, while Russia signed onto the Geneva Convention of War. Why do I believe diplomacy with Russia to achieve the same outcomes while limiting the spread of international terrorists would have been a far better idea?

USA militaries are not supposed to have decade long wars and sustained body counts. It is supposed to end the dangers to the country and civilization and pay reparations afterward. If the war is wearing on American's patience AND their treasury that is all part of the battlefield picture. I suggest Secretary Gates, the Joint Chiefs and their generals start assessing the battlefield as it is, not as a politician would want it to be.


In this photo taken Friday, Aug. 14, 2009, Lance Cpl. Joshua Bernard is tended to by fellow U.S. Marines after being hit by a rocket propelled grenade during a firefight against the Taliban in the village of Dahaneh in the Helmand Province of Afghanistan. Bernard was transported by helicopter to Camp Leatherneck where he later died of his wounds. (AP Photo/Julie Jacobson)

Elder organization states, "Senate Health Insurance Reform NOT Good Enough."


...B’nai B’rith has some major concerns about the Senate Finance bill, which would still allow charging older people significantly more for coverage," says its release. "The bill also lacks a workable mechanism – such as a public option – that would force insurance companies to compete for our business, even in traditionally monopolistic markets like rural areas. The weakness of incentives for employers to have and maintain coverage for their workers is also an issue. And we are also concerned about the failure to include the CLASS ACT (from the Senate HELP bill), which would encourage long-term coverage in a revenue-neutral way....

The equivalent of Duck and Cover. The Poles and Czechs will have to resort to diplomacy leading to peace rather than aggression.



...In one of the sharpest breaks yet with the policies of the Bush administration (click title to entry - thank you), Obama phoned the leaders of Poland and the Czech Republic last night to tell them that he had dropped plans to site missile interceptors and a radar station in their respective countries. Russia had furiously opposed the project, claiming it targeted Moscow's nuclear arsenal.
Obama is to announce the reversal officially at a news conference today. This morning the Czech prime minister, Jan Fischer, revealed that Obama phoned him about it last night....

Let's get started. Russia played a huge role in defeating Hitler's Nazi War Machine. Russia took and held an entire border of Germany by themselves, they were the first to discover the 'Nazi Death Camps' and they were the first to retake Berlin.

Russia and Poland continue to argue over the Second World War (click here)
This online supplement is produced and published by Rossiyskaya Gazeta (Russia), which takes sole responsibility for the content

On September 1, at the ceremony to mark the 70th anniversary of the Second World War in Poland, Russian Prime Minister Vladimir Putin and his Polish counterpart Donald Tusk exchanged barbs over the legacy of the war. But why has the controversy over historical memory erupted in recent years, and why can’t it be left to historians?...

Pope to be accompanied by 100 people on visit to Czech Republic (click here)

Benedict XVI, 82, and his team will fly to Prague aboard a plane of the Italian Airlines. He will return to Rome by a Czech special plane.
The Pope's team will also include a personal doctor, his assistant, two interpreters, an official photographer and three experts in liturgical ceremonies.
On the other hand, Benedict XVI never takes a personal cook to his trips abroad as he is not on a special diet, a clerk, from the Vatican administration, told CTK.
The Vatican also confirmed that Benedict XVI would spend two nights in the Czech Republic in the seat of the Vatican diplomatic mission in Prague, Federico Lombardi, spokesman for the Vatican state secretariat, told CTK.
Two bulletproof "papa-mobiles" (cars specially adjusted for the Pope) were sent to the Czech Republic two weeks ahead of the visit. A Czech policeman is to drive them.
Hundreds of Czech policemen will protect the Pope during his three-day visit to the Czech Republic on September 26-28.
The security measures are to be as tight as during the April visit by U.S. President Barack Obama to Prague....