U.S. Health Agency Predicts Higher Costs

Republican opponents of  the new health reform overhaul legislation must be dancing in the streets now as a new government report suggests what they have argued all along -- that health care costs will increase with seniors on Medicare taking the biggest hit.

A so-called panel of impartial economic experts at the Health and Human Services Department said the billions of dollars cut in Medicare, in particular, may be unrealistic and unsustainable. It also said the legislation will achieve President Obama's goal of adding 34 million Americans to health insurance coverage.

White House officials repeatedly claim such analyses have been too pessimistic, low-balling the law's potential savings.

The bad news coincided with a Congressional Budget Office revised estimate that 4 million Americans will be penalized for not buying health insurance as mandated in the law beginning in 2014.. This section of the overhaul legislation is being challenged in court by 13 states.

The Health and Human Services report carried a disclaimer from the Medicare's Office of the Actuary claiming the analysis does not represent the official view of the Obama administration.

The report said most of the costs will be sustained in the first decade because taxes on so-called Cadillac coverage by high income earners won't take effect until 2018.

"During 2010-2019, however, these effects would be outweighed by the increased costs associated with the expansions of health insurance coverage," wrote Richard S. Foster, Medicare's chief actuary. "Also, the longer-term viability of the Medicare ... reductions is doubtful." Foster's office is responsible for long-range costs estimates.

Rep. Dave Camp (R-Michigan) said the increased costs were expected all along and that the Medicare cuts will undermine coverage for seniors and require higher premiums. Other Republicans charged during the 15-month debate that health coverage for seniors would be rationed.

The health care law, passed by a divided Congress after bitter partisan debate, would create new health insurance markets for individuals and small businesses. Starting in 2014, most Americans would be required to carry health insurance except in cases of financial hardship. Tax credits would help many middle-class households pay their premiums, while Medicaid would pick up more low-income people. Insurers would be required to accept all applicants, regardless of their health.

In effect, the report indicated Obama's goal of near universal coverage being offset by cost-savings reforms missed the mark by $311 billion between 2010 and 2019. Translated into total health care spending during the decade, the amount surpasses $35 trillion.

The U.S. spends $2.5 trillion a year on health care now, far more per person than any other developed nation, and for results that aren't clearly better when compared to more frugal countries. White House officials argue the increase is a bargain price for guaranteeing coverage to 95 percent of Americans.

The report, contained on the Health and Human Services website, adds:

In addition to flagging the cuts to hospitals, nursing homes and other providers as potentially unsustainable, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program. Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer. Seniors leaving the private plans would still have health insurance under traditional Medicare, but many might face higher out-of-pocket costs.

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EPILOGUE

This report and an anticipated more to follow as the 2,400-page health reform law is dissected, adds ammunition to the arsenal Republicans plan to attack Democrats in the midterm elections. No Republican Congressman voted for the bill on the political gamble it would fail -- even if it was passed. Depending on the wording, few polls reflect voters view the law favorably. Despite the front loading of good features -- such as preventing insurance companies from dropping patients with preexisting conditions -- the full impact of the law will not be realized for at least five years and definitely not by the midterm elections just six months from now.

Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

While The Economy Sank, Some SEC Staff Watched Porn

While Wall Street financial manipulators concocted exotic deals to sink the economy, some of the top regulators and contractors regulating their activities at the Security Exchange Commission were watching pornography on government computers.

An internal memo written by SEC Inspector General David Kotz said 33 commission regulators downloaded the sexually explicit images on government time during a period when the financial markets were in peril and ultimately sent the economy into the worst crises since the Great Depression 70 years ago.

The leaked memo written at the request of an inquiry by Sen. Charles Grassley (R-Iowa) was first reported by ABC News, followed by CNN, the Associated Press and a number of websites including The Daily Beast.

Among the findings:

• A senior attorney at the SEC's Washington headquarters spent up to eight hours a day looking at and downloading pornography. When he ran out of hard drive space, he burned the files to CDs or DVDs, which he kept in boxes around his office. He agreed to resign, an earlier watchdog report said.
• An accountant was blocked more than 16,000 times in a month from visiting websites classified as "Sex" or "Pornography." Yet, he still managed to amass a collection of "very graphic" material on his hard drive by using Google images to bypass the SEC's internal filter, according to an earlier report from the inspector general. The accountant refused to testify in his defense and received a 14-day suspension.
• Seventeen of the employees were "at a senior level," earning salaries of up to $222,418.
• The number of cases jumped from two in 2007 to 16 in 2008. The cracks in the financial system emerged in mid-2007 and spread into full-blown panic by the fall of 2008.

Grassley is ranking minority member of the Senate Government Oversight Committee and supports regulation of derivatives included in the financial reform package now under consideration by Congress.

The first Congressman to comment on the memo was Rep. Darrell Issa (R-Calif.), ranking minority member of the House Committee on Oversight and Government Reform. “It is nothing short of disturbing that high-ranking officials within the SEC were spending more time looking at pornography than taking action to help stave off the events that brought our nation’s economy to the brink of collapse,” he said.

Salaries of the 33 SEC staff ranged between $99,000 and $223,000.

Investors and consumers lost trillions of dollars beginning with the housing market bubble bursting in 2007 that triggered the financial market collapse in September 2008.

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EPILOGUE

A word of caution. Although this is a news story because of its sexually suggestive content, it is only one tiny piece of the puzzle now being reconstructed on the events that plunged the nation into a catastrophic recession. The conduct of the SEC transgressors represents the complacent culture for lax regulation by the government watchdog agencies influenced by  policies and a laize faire attitude -- from top Congressional leaders of both parties and presidential administrations dating back to Ronald Reagan. They were the enablers for the Wall Street unabated risk takers. This story represents a picture of Nero fiddling while Rome burned.

Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

Mud Slings As Clock Ticks For Arizona Governor Signing Anti-Immigrant Law

 This is disgusting. Isn't there a grown-up in the house?

As the five-day time clock ticks down to zero for Arizona Gov. Jan Brewer to sign or veto the state Legislature's anti-illegal immigrant law, the bill's author and the cardinal of the Los Angeles Roman Catholic Diocese are engaging in a mud-slinging contest.

On Monday. Cardinal Roger Mahoney described the bill in terms of "Nazi" and "Communist," saying it was "the country's most retrogressive, mean-spirited, and useless anti-immigrant law," and "totally false reasoning: that immigrants come to our country to rob, plunder, and consume public resources."

On Wednesday, Arizona state Sen. Russell Pearce who crafted the bill requiring immigrants to carry proof of legal status, called Cardinal Mahoney  "a guy who's been protecting child molesters and predators all of his life."

"He's the last guy that ought to be speaking out," Pearce said on the Michael Smerconish program, a nationally syndicated radio talk show. "This guy has a history of protecting and moving predators around in order to avoid detection by the law. He has no room to talk."


And, that, according to the Los Angeles Times led to this rebuttal by Tod M. Tamberg, the cardinal's spokesman.

"Mudslinging and fearmongering are the essence of Sen. Pearce's remarks. He desperately wants to change the subject, throwing up a wall of inaccurate statements about Cardinal Mahony because he has no good answer to the cardinal's challenge that this is a draconian and unjust law."

The law would allow police without probable cause to ask legal status of Hispanics suspected to be in the country illegally as well as barring people from soliciting work or hiring workers without documentation, a provision aimed at the day labor trade.

On the talk show, Pearce said "We love and admire immigrants who come here to assimilate to be Americans. It his has nothing to do with immigration. It has to do with those who enter our country illegally."

The Republican senator said the cardinal was ignoring the plight of countless crime victims of illegal immigrants, including police officers who have been killed and teenage girls who have been kidnapped and raped. In a high-profile recent case, authorities suspect an illegal immigrant shot and killed Arizona rancher Robert Krentz, who was found dead on his property.

Meanwhile, Latino advocacy groups and labor leaders are venting their wrath at President Obama for failing to fulfill campaign promises of immigration reform and accusing the president of continuing Bush administration policies of deporting hardworking Mexican laborers rather than criminals.


In at least one case involving Ulises Martinez-Silver and Saturnina Martinez of Las Vegas who were brought to the United States by their families as infants, the Department of Homeland Security said that it would indefinitely suspend action against them.

Their case was brought to the 9th Circuit Court last year by the Obama administration that disgusted the three-judge panel. One judge said the government's case was "horrific" against the couple, he a carpenter and she a clerk, with no criminal records and having U.S. born children ages 8 and 12.

Another judge labeled it the "most senseless result possible." A third complained of "an extraordinarily bad use of government resources."

"These people have worked hard. They have paid their taxes," Judge William Fletcher said. "Why don't you go after the bad guys?"


The Times provided the following rebuttals and immigration perspectives.

John T. Morton, the former Justice Department prosecutor who runs the Homeland Security Department's Immigration and Customs Enforcement agency, or ICE, disputed the criticism brought by the advocacy groups. His agency has prioritized deporting criminals, he said, noting that removals of such immigrants were slated to increase 40% this year.

Morton expressed frustration over what he considers exaggerated and unfair charges from immigrant rights activists. The agency frequently allows immigrants to remain even when the law says they should be removed, he said. "We exercise discretion all of the time," Morton said.

And,

As a presidential candidate, Obama spelled out his immigration policy in a June 2008 speech at the National Council of La Raza, a Hispanic civil rights organization, saying: "When communities are terrorized by ICE immigration raids, when nursing mothers are torn from their babies, when children come home from school to find their parents missing, when people are detained without access to legal counsel – when all that is happening, the system just isn't working, and we need to change it."



And,

An analysis by the nonpartisan Transactional Records Access Clearinghouse at Syracuse University shows that the proportion of criminal immigrants in detention rose from 27% in 2009 to 43% in 2010. However, that statistic reflects only a "relatively small number" of people guilty of serious offenses like armed robbery, drug smuggling and human trafficking, the report said. Most are guilty of minor offenses such as traffic violations or disorderly conduct. Immigration violations such as illegal entry into the United States are also included.


Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

Says Harry Reid's Republican Opponent -- A Chicken In Every Pot

 Democrats and progressives can't believe their good fortune that Nevada Republican senatorial candidate Sue Lowden wants to lower health care costs by adopting a barter economy to pay doctors.

Lowden insists she's not fooling around in an effort to unseat incumbent Harry Reid, Senate Majority Leader who has been trailing in the polls in his home state against phantom opponents for nearly two years.

Here's two video tapes provided by Talking Points Memo although I think Rachael Maddow was a little too cutesy in her presentation Wednesday night on her MSNBC show.


Here's the key text:

"Let's change the system and talk about what the possibilities are. I'm telling you that this works. You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say I'll paint your house," she said. "[That's] what people would do to get health care with their doctors. Doctors are very sympathetic people."
"I'm not backing down from that system," she added.

 Also Wednesday night, Lawrence O'Donnell, once again filling in for an absent Keith Olbermann, said Reid deserves a "Profiles In Courage" award for steering the health reform overhaul legislation through the Senate at a time he knew his constituents opposed the measure.

Talking Points itself wrote:


...Many people had endless criticisms of how he managed the process over the course of 2009 and 2010. At the end of the day, though, it passed. The Senate is where it happened. And Reid was central to the entire thing. That is an historic accomplishment. If his career in politics ends in January, his place in history will be secure.

In January, the Las Vegas Journal-Review paid the Mason-Dixon Polling and Research Inc. for a poll interviewing 625 voters in which half held an unfavorable view and 45% said they definitely would vote against Reid.

As for Lowden, TPM wrote:

There's no end of comedic possibilities thinking through the logistical and logical difficulties of managing co-pays and long-term care and drug costs in chickens and other barter payment. But step back and give it a serious look and ... well, this is this woman's take on confronting medical inflation. It's funny and also sad. But as a contrast it's stark and painful.

Reid's campaign released a statement headed  "Seriously ... Has Sue Lowden Lost Her Mind?"

Mason-Dixon Managing Partner Brad Coker commenting on the January poll: "Reid's fortunes are going to hinge on two things: Does he draw a strong challenger, and what does the economy do."

The answer to the first point is clear.

 The other declared Republican candidate for Senator is former UNLV coach's son Danny Tarkanian. He has yet to announce a full court press on his opponents.

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EPILOGUE

I'll leave the chicken jokes to the comics and hope Jon Stewart of "The Daily Show" on Comedy Central takes the bait. Historically, it was President Herbert Hoover who campaigned for reelection in 1932 coining the phrase "A Chicken In Every Pot" as the rallying cry during the height of the Great Depression. On her Web site, Sue Lowden writes: "I’m running for the U.S. Senate in Nevada to create jobs, restore accountability in government spending and to fight for your interests over those of Nancy Pelosi, Harry Reid and Barack Obama." I don't live in Nevada, but if I did and was a doctor, I'll be damned if I would allow a cow or herd of goats in my reception room. But, only because it is unsanitary.


Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

By Working Together, A Case Study On How To Reduce Health Costs

Think of all the hours we have sat alone in private patient rooms waiting for the doctor to attend our needs. If you are like me, you pass the boredom by reviewing all the medical wall posters. We have all seen them. An artist's rendering of the heart and all its components. Same for lungs. Kidneys. Then the granddaddy of them all -- the body's entire arterial and venus blood highways.

Each and every poster is provided by a drug or medical device manufacturer. They are informative and educational.

Sometimes at the end of the doctor's examination, a brand drug will be prescribed. Oftentimes, the doctor is unaware if it has a generic competitor.

Here's another scenario. While waiting in the reception room, a drop-dead gorgeous young woman dressed in a conservative dark blue suit with hems set seductively an inch below the knees walks into the office with a brief case on wheels. A word with the receptionist and minutes later is talking to the doctor you've been waiting for a half hour.

She's a pharmaceutical sales woman or, in my case, a rep from Medtronic, the largest and most successful insulin pump and medical devise manufacturer in the nation.

You can see where this is headed.

How beholden are our physicians to the drug and medical devise industry. It is true that doctors are held accountable for ethics and medical standards by their peers and in most states by governing boards. But nothing happens unless a peer snitches on another doctor or a patient files a complaint.

Some of the most comical ads on TV is when an agent of Big Pharma says to ask your doctor about prescribing its product and then spends three-quarters of the remaining ad time warning of all the side effects.

Sometimes the ad says call your doctor immediately if those side effects appear. If your doctors are like mine, good luck because those return calls will not set any land speed records. It's not because they consider you a hypochondriac. Usually, they're busy, and equally important, don't get paid for call backs.

It is with some consolation that the Council of Medical Specialty Societies issued new ethics codes Wednesday to limit the influences that drug and device makers have over patient care. It is billed as the most sweeping move ever taken by the group which represents 32 medical societies with 650,000 members.

"We take very seriously the trust that is placed in us by physicians and patients to be authoritative, independent voices in cancer care," said Dr. Allen Lichter, chief of the American Society of Clinical Oncology. He led the panel that developed the code.

The most controversial and strongest rule requires leaders of any medical society and editors of its journals from consulting deals or financial ties to Big Pharma.

The code requires groups to:

• Publicly post any industry support the group receives, such as money for continuing education sessions.
• Decline industry funding for developing medical practice guidelines, such as who should get a drug, a test or treatment. Require that most members of a guidelines panel be free of financial ties to industry.
• Disclose any financial ties that leaders and board members have with companies.
• Ban company or product names and logos from pens, bags and other giveaways at conferences.

During the recent national debate on health reform, Big Pharma took a hit as one of the bad guys driving health costs up.

What was lost in the hysteria is that the major drug companies offer free or copays ranging as high as $10 for a 30-day prescription to low income patients on Medicaid.

In my case, Medtronic through my endocrinologist implanted at no cost to me an electronic chip that monitored my blood sugars ever five minutes over a 72-hour period. Health Net, my insurance carrier, refused to cover the expensive procedure. 

It was the first time my blood sugars were continuously tracked, finally allowing the doctor and I to adjust the insulin dosages for my diabetes 24/7. My blood glucose has been under control ever since with only sporadic deviations.

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EPILOGUE

For the new health reform legislation to work, this absurd call of resistance led by right wing-nuts of a government takeover must end. Treatment of diabetes is one of the most expensive causes for skyrocketing costs among all the major diseases. In my case, working with my doctors, the insurance carrier, drug and medical devise manufacturers, my cost of treatment has been reduced by about 75% in the past year.

Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

Exposing The Culture Of Political Donations

The main stream media and the Internet bloggerheads, in their infinite wisdom, place an inordinate amount of emphasis on how much money a political party or candidate raises for their elections.

As a student of political science, I view fund raising success as a major player but not the only one by far in judging the outcomes of pending elections.

No question money talks. The extreme examples are millionaires such as Michael Bloomberg and John Corzine essentially buying their way into office of New York City Mayor and U.S. Senator and governor of New Jersey, respectively.

But as The Moderate Voice's knowledgeable Joe Gandelman notes in a post Wednesday, money isn't everything. His argument that the Democrats' major fund raising committees raised $29 million in March compared to the Republicans' $24 million doesn't mean squat (my word, not his).

There are no guarantees in politics even though money is the mother's milk of the process.

The question I ask, is donating to a political campaign a wise investment. It almost always is for the beneficiary. Ask yourself when was the last time a President of the United States was not richer two years after leaving office than he was before his election. The most recent examples parlaying the metophoric rags to riches theme are Jimmy Carter and Bill and Hillary Clinton.

On Wednesday the Washington Post reported findings of an analysis they paid for detailing questionable expenses the two national political parties filed with the Federal Elections Commission. Keep in mind the money came from private donations. I will list one example from each party.

The RNC's expenditures for "office supplies" in the period through February topped $773,000, according to a Post tally, including jelly beans for (RNC Chairman Michael) Steele's office and thousands of dollars' worth of liquor and wine. Although not asked to review specific party expenditures, Mindy Kramer, an Office Depot spokeswoman, said that in general, firms with 100 office workers -- about the size of the RNC headquarters staff -- spend $30,000 to $50,000 a year on supplies. 

And, on a smaller scale, the DNC spent $666 for "rental" costs at a store called Tiny Jewel Box in which store personnel were unaware of any DNC event.

The truth is these campaign spending reports are lame efforts by both national committees to comply with FEC questions they deem as too broad, leading to clerical filing errors.

They make good copy, as we say in the trade, but signify almost nothing.

But the Post story did shed light on a couple of areas that are important. For instance, the analysis said the Democrats spend about 59% of total donations on administrative costs for every $100 million collected while the Republicans spent 68% or $74 million of $109 million in revenue.

Meanwhile, the typical nonprofit organization, the Post reported, holds administrative expenses and fundraising to no more than 25% of income.

Ken Berger, who runs Charity Navigator, a New Jersey group that monitors nonprofits across the country, said that "the most critical measure is effectiveness." He said his advice for prospective donors to any nonprofit group that spends as much as 60 to 70 percent of revenue on overhead, including fundraising, would be to "run away." 

My conclusion is political cash donors don't give a damn how the money is spent as long as it gets results.

It is the same culture as we see in financial institutions where executives and aggressive brokers are compensated in the millions even if they bet on bad risks that drive the economy into a meltdown.

It has occurred to me that people who receive nothing in return for donating to a political cause may be the same ones who claim they pay too much in taxes to the governments.

Is America great or what?

Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer

What If The NFL Ruled America's Conduct

News flash:

NEW YORK - Pittsburgh Steelers quarterback Ben Roethlisberger was suspended for six games without pay Wednesday for violating the NFL’s personal conduct policy and ordered to undergo behavioral evaluation.

Commissioner Roger Goodell handed down the punishment a week after prosecutors decided not to charge Roethlisberger in a case involving a 20-year-old college student who accused him of sexually assaulting her in a Georgia nightclub in March.

Goodell said the league’s conduct policy gave him the right to impose discipline regardless of whether he broke the law. 

That got me to thinking.

Wouldn't it be appropriate for elected and private officials holding the public trust be held accountable by a higher authority than the existing legal parameters?

What if a person winning a public office seat or anyone handling someone else's money had to sign a good conduct policy such as mandated to play or be employed in the National Football League?

Let me don my hat as commissioner, a title I prefer over czar which is the nom de plume thrust on presidential advisers who skirt Senate confirmation.

I would levy treble damages for innocent investors bilked by Goldman Sachs in the federal civil suit filed against them by the Securities Exchange Commission. I would ban for life John Paulson, the hedge fund operator who instigated the scheme, from touching a dime of someone else's money.

I would suspend Republican Sen. John Ensign of Nevada from running for public office for six years subject to psychological evaluation by a sex and ethics specialist.

I would establish a branch of the commissioner's office called "Liar, Liar, Pants On Fire," which would fine offenders one day's pay for each offense.

I would deport South Carolina Gov. Mark Sanford to Argentina.

I would retain my sense of humor despite the horror these people inflict on the masses.

As you can see, the NFL has a benevolent dictatorship in place. In my younger days, I was crushed when the NFL suspended Green Bay Packers star Paul Hornung and Detroit Lions bully Alex Karros for a full season because of gambling.

Baseball banned Shoeless Joe Jackson and Pete Rose for life, also for gambling.

Yet, no sport commissioner ever banned a player for life for substance abuse.

The six-game suspension for Roethlisberger will cost him $2.8 million. In a letter to the player, the commissioner wrote:

"Your conduct raises sufficient concerns that I believe effective intervention now is the best step for your personal and professional welfare. In your six years in the NFL, you have first thrilled and now disappointed a great many people. I urge you to take full advantage of this opportunity to get your life and career back on track."

I rest my case.

Readers comments are welcome as long as they remain civil. We reserve the right to delete any comments that are vulgar, libelous and totally irrelevant to this posting. -- Jer