Posts Tagged ‘Medicaid’
Posted by Warm Southern Breeze on Friday, December 20, 2013
Did you know? (No, you probably didn’t.)
In a report dated August 2013, the Department of Health and Human Services Office of Inspector General (HHS OIG) conducted a criminal and administrative investigation and found that Alabama claimed, and was paid millions in unallowable performance bonus payments under the Children’s Health Insurance Program Reauthorization Act (CHIRPA).
This FRAUD was because of INCOMPETENCY in Alabama governance.
The HHS OIG found that the Alabama state agency overstated its FYs 2009 and 2010 current enrollment in its requests for bonus payments. The State agency overstated its current enrollments because, rather than Read the rest of this entry »
Posted in - Business... None of yours, - My Hometown is the sweetest place I know, - Read 'em and weep: The Daily News | Tagged: abuse, ACA, Alabama, Alabama Legislature, Associated Press, Barack Obama, Bentley, budget, Centers for Medicare and Medicaid Services, children, CHIP, CHIRPA, CMS, Crimson Tide, defraud, federal, Federal government of the United States, fraud, GOP, government, governor, health, HHS, incompetence, incompetency, insurance, Medicaid, Mississippi, money, Montgomery Alabama, news, Obamacare, OIG, Patient Protection and Affordable Care Act, politics, PPACA, quiet, Republican, Robert Bentley, Robert J. Bentley, State Children's Health Insurance Program, United States, waste | 2 Comments »
Posted by Warm Southern Breeze on Thursday, June 27, 2013
If you had an option, would you rather pay $10/month, or $80/month for a prescription medication that accomplished/did the exact same thing?
Research shows that the results of the 2 differently priced medicines have never been shown to be any better in any way.
Which would you choose?
What if your doctor prescribed the more expensive medication for you based on the fact that Read the rest of this entry »
Posted in - Do you feel like we do, Dr. Who?, - Read 'em and weep: The Daily News | Tagged: $62 billion, abuse, ACA, Affordable Care Act, Archives of Internal Medicine, avarice, Big Pharma, biotech, blood pressure, cardiology, cheat, crime, DO, doctor, drug, elderly, ethics, Forest Laboratories, fraud, GPO, greed, group purchasing organizations, health, healthcare, honesty, kickback, law, lie, manufacturers, MD, Medicaid, Medical device, Medicare, medication, medicine, money, Obamacare, patient, pharmaceutical, physician, PPACA, ProPublica, steal, taxes, taxpayer, teaching hospital, Thomas Aquinas, waste | Leave a Comment »
Posted by Warm Southern Breeze on Friday, February 22, 2013
Realistically, what does that mean for you, your loved ones or friends if – God forbid – they’re hospitalized at Huntsville Hospital?
It means that when you, your loved ones’ or friends’ are a patient in the hospital, you or they could get an infection, or some other serious bug or problem while being treated for something else entirely different. And by so doing, it could make your stay more unpleasant, and in fact, could increase the risk of complications of your treatment – up to, and including your death – was well as increase the length of your stay, among other factors.
What does that mean for the Hospital?
Because insurance companies and Medicare/Medicaid have STOPPED paying for the treatment of preventable problems that are a direct result of hospitalization, it means that Huntsville Hospital will be stuck with the bill (the costs of treating their own mistakes upon you while you’re there)… and will try to pass the cost along to you to recoup the cost of the loss, which is a DIRECT result of their own sloppiness.
Huntsville Hospital has essentially become a monopolistic monstrosity of an enterprise, gobbling up numerous hospitals in the North Alabama region, including BOTH hospitals in Decatur, the only hospital in Athens, the only hospital in Red Bay, Helen Keller Hospital in Tuscumbia area of the Shoals, and the only hospital in Lawrence county.
Meanwhile, Huntsville hospital has fought tooth-and-nail to keep other hospitals OUT of competition in the Huntsville market, and spent untold millions of dollars in a protracted legal battle against Crestwood Hospital – and continues to spend millions to prevent Crestwood Hospital from offering services that would benefit the entire city and county.
Such anti-competitive practice has all been accomplished by and through the state of Alabama‘s Certificate Of Need Board.
The commentary of Mr. Burr Ingram – Huntsville Hospital’s official mouthpiece – which is contained in this article is entirely and wholly unwarranted, and weasel-like.
Not only that, but Huntsville Hospital is NOT a Nursing Magnet Hospital.
There are many things Huntsville Hospital is not.
And sadly, quality is one of them.
Watchdog Report: Consumer Reports gives both hospitals in Huntsville low safety ratings
Published: Thursday, July 12, 2012, 9:06 AM Updated: Thursday, July 12, 2012, 9:30 AM
HUNTSVILLE, Alabama – Consumer Reports magazine ranked the two hospitals in Huntsville as the least safe in Alabama. But the magazine’s list of hospitals is far from complete.
“We were kind of perplexed at some of what it reported,” said Burr Ingram, spokesman at Huntsville Hospital. “When you think about it, it’s fashionable for everyone to rate hospitals. And Consumer Reports is the latest to use public data that is available.
“But at times, it’s difficult to know how these ratings come about.”
Huntsville Hospital, The Huntsville Times
The magazine’s August edition lists scores in four safety categories. Both Huntsville Hospital and Crestwood Medical Center received low marks for poor communication with patients and for high rates of infection. Both received mediocre marks for high rates of re-admission and unnecessary scans.
Yet the report ranked Read the rest of this entry »
Posted in - My Hometown is the sweetest place I know, - Politics... that "dirty" little "game" that first begins in the home., - Read 'em and weep: The Daily News | Tagged: AL, Alabama, battle, Burr Ingram, CEO, Certificate of Need, CMS, CON, Consumer Reports, court, Crestwood, Crestwood Medical Center, David Spillers, disease, doctor, fight, greed, health, Health Reimbursement Account, healthcare, hospital, Huntsville, Huntsville Hospital, Huntsville Hospital System, Huntsville Times, infection, insurance, law, legal, liars, MD, Medicaid, Medicare, money, monopoly, news, Nurse, patient, physician, publicity, reimbursement, RN, sick, sickness, sicko, spokesman, state, United States, wellness | Leave a Comment »
Posted by Warm Southern Breeze on Friday, December 28, 2012
GOP Governors Deny The Poor Health Care In Opposing Obamacare‘s Medicaid Expansion
December 28, 2012
Posted: 12/28/2012 8:44 am EST | Updated: 12/28/2012 12:18 pm EST
Texas Gov. Rick Perry, right, and Louisiana Gov. Bobby Jindal in De Witt, Iowa, Tuesday, Dec. 20, 2011. Both Republican governors — along with those in Oklahoma, Alabama, Mississippi, Georgia, South Carolina, South Dakota and Maine — have rejected an expansion of Medicaid in their states. (AP Photo/Chris Carlson)
RUSTON, La. — With no health insurance and not enough money for a doctor, Laura Johnson is long accustomed to treating her ailments with a self-written prescription: home remedies, prayer and denial.
Over decades, she made her living assisting elderly people in nursing homes in jobs that paid just above minimum wage and included no health benefits. So even as her feet swelled to such an extent that she could no longer stuff them into her shoes, and even as nausea, headaches and dizziness plagued her, she reached for the aspirin bottle or made do with a teaspoon of vinegar. She propped her feet up on pillows and hoped for relief.
“Before I got sick,” she said, “I hadn’t been to the doctor in 20 years.”
After she collapsed last year and landed in in a local emergency room, doctors diagnosed her with congestive heart failure, high blood pressure and hypothyroid. They ordered her not to work. She arranged a Social Security disability benefit, and she enrolled in Medicaid, the government-furnished insurance program for the poor. She used her Medicaid card to secure needed prescription medications. Her ailments stabilized.
But this year, the state determined that the $819 a month she draws in disability payments exceed the allowable limit. By the federal government’s reckoning, her $9,800 annual income made her officially poor. But under the standards set by Louisiana, she was too well off to receive Medicaid.
This is how Johnson, 57, finds herself back amid the roughly 49 million Americans who lack health insurance. This is why she must again reach into her pocket to secure her prescription drugs, a supply that runs about $200 a month. That sum is beyond her, so she has gone more than four months without taking her pills on a regular basis. Once again, her feet are swelling and her chest is filling with fluid. Once again, she is confronted with the realization that a lifetime of labor does not entitle her to see a doctor any more than it enables her to gain crucial medications.
“It just doesn’t seem right to me,” she said. “It just doesn’t seem fair.”
Johnson is precisely the sort of person who is supposed to Read the rest of this entry »
Posted in - Politics... that "dirty" little "game" that first begins in the home., - Read 'em and weep: The Daily News | Tagged: Bobby Jindal, health insurance, Laura Johnson, Louisiana, Medicaid, Obamacare, Patient Protection and Affordable Care Act, Republican Governors Association, South Carolina, United States | Leave a Comment »
Posted by Warm Southern Breeze on Tuesday, December 4, 2012
Welcome to Alabama, where the legal concept of respondeat superior apparently does NOT apply.
Some would call this murder.
If a person driving drunk kills someone, nowadays, they’re charged with murder – even though they did not plan, or intend upon killing someone (the element of premeditation, or forethought).
But why isn’t Huntsville Hospital charged with murder? (It’s kinda’ difficult to charge a corporation with murder, but it’s quite possible that the officers can be indicted or charged.)
And why aren’t those directly responsible (those in the Recovery Room who were responsible for Gracie’s care) charged with Murder?
It’s painfully obvious some things MUST change in Alabama regarding healthcare.
Girl disabled, later dies, after tonsillectomy at Huntsville Hospital; Alabama public hospitals‘ liability capped at $100,000
By Challen Stephens | firstname.lastname@example.org on December 03, 2012 at 1:03 PM, updated December 03, 2012 at 4:18 PM
Randy Smith and Deedee Smith talk about raising a child with disabilities while Gracelynn, 5, sits in her wheelchair during an interview in their home Monday, November 19, 2012 in Athens, Ala. (Eric Schultz / email@example.com)
HUNTSVILLE, Alabama — Four years ago, Gracie knew a few dozen words and had just learned to walk backwards. But Gracie had a little trouble breathing at night. Doctors said it would only get worse, so they decided to remove her tonsils.
The surgery lasted less than 15 minutes.
In the recovery room at Huntsville Hospital, Gracie was standing on her bed calling for her mother. “We were told she was having difficulty coming out of anesthesia,” said her father Randy Smith. Nurses said the girl needed to rest to recover. In the recovery room, the family says, she was allowed to stop breathing for more than 10 minutes.
Dan Aldridge, attorney for the Smiths, said Gracie “was not connected to the customary monitoring equipment that sounds an alarm if vital signs reach a dangerous zone.” He said the nurses, three of them, were in the recovery room. At one point, her mother voiced concern. “I was told, ‘Mom, now don’t wake her up, if we get her up, we will never calm her down,” said Dee Dee Smith. “My response was she was not breathing.”
Dee Dee said one of the nurses touched the girl’s foot. It was cold. Aldridge said “code” was called. Medical staff poured into the room. Gracie would spend the next 18 hours in a coma. When Dee Dee finally got to hold her girl again, the girl’s eyes were open but Read the rest of this entry »
Posted in - Lost In Space: TOTALLY Discombobulated, - My Hometown is the sweetest place I know, End Of The Road | Tagged: Alabama, Athens, Birmingham, Bureau of Labor Statistics, child, Christmas, dead, Dee, died, disabled, fraud, funeral, girl, Gracie, harm, hospital, Huntsville, Huntsville Hospital, Huntsville Hospital System, hurt, immunity, incompetent, liability, limited, Medicaid, PACU, pediatric, peds, Post Anesthesia Care Unit, public, respondeat superior, Santa Claus, Smith, Smiths, surgery, tonsillectomy, twin, unequal | 7 Comments »
Posted by Warm Southern Breeze on Friday, November 16, 2012
Not only are you, Governor Bentley, an embarrassment to the state and nation, but as a physician, you discredit the healing arts & profession, and contribute to sickness, disease and ill health of the people of the great state of Alabama.
By Kim Chandler | firstname.lastname@example.org
on November 16, 2012 at 12:07 PM, updated November 16, 2012 at 5:35 PM
Alabama Governor Dr. Robert Bentley, MD (R), adamantly refuses to help the state’s citizens by making a list of health insurance carriers, called an “exchange.” – (AP photo)
MONTGOMERY, Alabama — At the request of some GOP governors, the federal government is giving states another month to decide if they want to run a state-based health insurance exchange.
Gov. Robert Bentley is saying no thanks to the extra time, saying his decision stands to not set up a state exchange.
“The extension from HHS did not change the governor’s decision,” Bentley Press Secretary Jennifer Ardis said in an e-mail.
Bentley, as other GOP governors have done, announced Tuesday that he would not set up a state exchange under the Affordable Care Act.
Bentley made the announcement official in a two-sentence letter today to HHS Secretary Kathleen Sebelius.
“This letter serves as official notification that Alabama will not be setting up a state-based health insurance exchange, nor do I intend to pursue a partnership exchange,” Bentley wrote.
Today had been the deadline for states to decide whether they want to set up and run their own state exchange, essentially a marketplace for people and businesses to shop for insurance with some people getting subsidies to offset their costs.
Sebelius sent a letter Thursday to Gov. Bobby Jindal of Louisiana and Gov. Bob McDonnell of Virginia saying that deadline has been extended until Dec. 14.
The governors, on behalf of the Republican Governors Association, had requested more time to make a decision, according to the letter from Sebelius. Both Jindal and McDonnell have said they don’t plan to set up an exchange.
“We are confident Governors will have enough time to Read the rest of this entry »
Posted in - Lost In Space: TOTALLY Discombobulated, - My Hometown is the sweetest place I know, - Politics... that "dirty" little "game" that first begins in the home., - Read 'em and weep: The Daily News | Tagged: Alabama, Bentley, Bob McDonnell, Bobby Jindal, exchange, GOP, governor, health, Health Insurance Exchange, healthcare, insurance, insurance exchange, Kathleen Sebelius, Medicaid, news, politics, Republican, Republican Governors Association, Robert Bentley | Leave a Comment »
Posted by Warm Southern Breeze on Tuesday, November 13, 2012
Governor Bentley is pulling a George Wallace stand-in-the-schoolhouse-door redux.
What an ignorant ass he is!
It’s exceedingly sad that he – as a physician – ordered Alabama’s 67 Counties Departments of Public Health to STOP giving Tuberculosis tests, thereby jeopardizing the public health of everyone who eats at a public restaurant, works in healthcare, and more – and was done as super-virulent, drug-resistant strains of tuberculosis are emerging. Gee, thanks, Governor Dr. Bentley. NOT!
Thanks for nothing, you jack-legged nincompoop!
By your defiant actions, Governor Bentley, you will FORCE the Federal Government to do something TOTALLY against your opinion – and that is, to establish a Health Insurance Exchange in Alabama.
You, Governor Bentley, are a lazy, sorry, idiotic jerk, in addition to being a liar, thief, incompetent boob, and contemptuous good-for-nothing.
Pejoratives aside, more than anything, this places the solitary onus of responsibility upon the governor and legislature to 1.) Increase education,; 2.) Increase employment; 3.) Increase Corporate Income Tax rates; and 4.) Increase Personal Income Tax rates on the wealthiest Alabamians who already pay a well-documented rate that is significantly lower than the impoverished.
By increasing educational attainment in Alabama, the governor will be demonstrating a high-quality, high-yield investment in the state’s most precious resource – people.
But the governor – bless him – is ignorant, and it is quite painfully obvious that he just doesn’t understand such simple concepts. He should understand them, however, because he has said previously, that he used the G.I. Bill to complete his medical training after his enlistment ended.
In stark contrast, Tennessee’s Republican governor, Bill Haslam said, “I’ve always said from the very beginning that anything we [Tennessee] can run instead of the federal government, we are going to run it better and cheaper,” The simpler thing to do is to say, ‘Here, it’s your idea, you run it,’ but I’m not convinced yet that that’s what’s best for our citizens. There’s going to be an exchange and ultimately, our citizens — through their insurance companies — are going to pay for the costs of running that exchange. So who do we think can run it cheaper: us or the federal government? I’ll bet on us every time. But we have to be convinced that the flexibility they will give us is worth taking the risk of running it ourselves.”
For the benefit of the reader who may be unaware of what an Insurance Exchange is, the exchange is designed to allow uninsured people to compare and buy health insurance plans through a single Internet portal. Those who earn up to four times the federally designated poverty level will receive subsidies to pay for the coverage.
Essentially, it’s an Internet-based non-business (nobody is making any money), that creates a database of health insurance carriers that all adhere to certain guidelines for efficiency and coverage. The law allows states to join together to run multi-state exchanges – essentially, insurance across state lines – or to exclude themselves.
In essence, make a list of companies that sell health insurance in the state, make a comparison of their plans and prices, and provide a link to the company for folks to buy insurance from whatever company they want.
Not too difficult to figure out, eh?
Here’s a link to an informative flyer from the Henry J. Kaiser Family Foundation about what Health Insurance Exchanges are, and what they do.
You may also be interested in reading the informative site http://healthreform.kff.org.
Gov. Bentley says Alabama won’t set up exchange, expand Medicaid
By Kim Chandler | email@example.com
on November 13, 2012 at 1:38 PM, updated November 13, 2012 at 5:19 PM
Bentley, in a show of continued resistance to the Affordable Care Act, said this afternoon that he will not set up a state health care exchange and he will not expand Medicaid under the federal healthcare overhaul.
Alabama Governor Robert Bentley speaks at the Birmingham Business Alliance 2012 Governor’s Luncheon in Birmingham, Ala., Tuesday, Nov. 13, 2012. (Tamika Moore | firstname.lastname@example.org) / Tuesday, November 13, 2012 1:17 PM
“I will not set up a state exchange in Alabama,” Bentley said during a speech to the Birmingham Business Alliance.
States have a Friday deadline to inform the U.S. Department of Health and Human Services if they plan to set up a state-run exchange, essentially a marketplace for people and businesses to shop for insurance. If states don’t set up their own exchange, either alone or in federal partnership, then the federal government will step in and design it.
Bentley said he has been in communication with other governors — including peers in Texas, Florida and Louisiana — about the exchange decision. He expected multiple governors to show a united front of resistance to the Affordable Care Act.
“If we stand together, I do believe Congress is going to have to look at this again,”Bentley said.
Bentley said he expected other governors to announce similar decisions.
“That will Read the rest of this entry »
Posted in - Did they REALLY say that?, - Lost In Space: TOTALLY Discombobulated, - Politics... that "dirty" little "game" that first begins in the home. | Tagged: Affordable Care Act, Alabama, Bentley, Bill Haslam, efficient, exhange, federal, GOP, health, Health Insurance Exchange, healthcare, incompetent, insurance, law, liar, Medicaid, Mike Hubbard, Obamacare, Patient Protection and Affordable Care Act, Republican, Robert Bentley, Roger Bedford, Tennessee, thief, United States, United States Department of Health and Human Services | Leave a Comment »
Posted by Warm Southern Breeze on Sunday, October 28, 2012
Brer Fox leapt out of the bushes and strolled over to Brer Rabbit. “Well, well, what have we here?” he asked, grinning an evil grin.
Brer Rabbit gulped. He was stuck fast. He did some fast thinking while Brer Fox rolled about on the road, laughing himself sick over Brer Rabbit’s dilemma.
“I’ve got you this time, Brer Rabbit,” said Brer Fox, jumping up and shaking off the dust. “You’ve sassed me for the very last time. Now I wonder what I should do with you?”
Brer Rabbit’s eyes got very large. “Oh please Brer Fox, whatever you do, please don’t throw me into the briar patch.”
“Maybe I should roast you over a fire and eat you,” mused Brer Fox. “No, that’s too much trouble. Maybe I’ll hang you instead.”
“Roast me! Hang me! Do whatever you please,” said Brer Rabbit. “Only please, Brer Fox, please don’t throw me into the briar patch.”
“If I’m going to hang you, I’ll need some string,” said Brer Fox. “And I don’t have any string handy. But the stream’s not far away, so maybe I’ll drown you instead.”
“Drown me! Roast me! Hang me! Do whatever you please,” said Brer Rabbit. “Only please, Brer Fox, please don’t throw me into the briar patch.”
“The briar patch, eh?” said Brer Fox. “What a wonderful idea! You’ll be torn into little pieces!”
Grabbing up the tar-covered rabbit, Brer Fox swung him around and around and then flung him head over heels into the briar patch. Brer Rabbit let out such a scream as he fell that all of Brer Fox’s fur stood straight up. Brer Rabbit fell into the briar bushes with a crash and a mighty thump. Then there was silence.
Brer Fox cocked one ear toward the briar patch, listening for whimpers of pain. But he heard nothing. Brer Fox cocked the other ear toward the briar patch, listening for Brer Rabbit’s death rattle. He heard nothing.
Then Brer Fox heard someone calling his name. He turned around and looked up the hill. Brer Rabbit was sitting on a log combing the tar out of his fur with a wood chip and looking smug.
“I was bred and born in the briar patch, Brer Fox,” he called. “Born and bred in the briar patch.”
And Brer Rabbit skipped away as merry as a cricket while Brer Fox ground his teeth in rage and went home.
Insurers Profit From Health Law They Fought Against
By Sarah Frier – Jan 5, 2012
Insurance companies spent millions of dollars trying to defeat the U.S. health-care overhaul, saying it would raise costs and disrupt coverage. Instead, profit margins at the companies widened to levels not seen since before the recession, a Bloomberg Government study shows.
Insurers led by WellPoint Inc. (WLP), the biggest by membership, recorded their highest combined quarterly net income of the past decade after the law was signed in 2010, said Peter Gosselin, the study author and senior health-care analyst for Bloomberg Government. The Standard & Poor’s 500 Managed Health-Care Index rose 36 percent in the period, four times more than the S&P 500.
“The industry that was the loudest, most persistent critic of this law, the industry whose analysts and executives predicted it would suffer immensely because of the law, has thrived,” Gosselin said. “There is a shift to government work under way that is going to represent a fundamental change in their business model.”
Health insurers contributed $86.2 million to the U.S. Chamber of Commerce to oppose the law after Obama administration officials criticized the plans for enriching themselves by raising customer premiums.
“We remain very concerned that Read the rest of this entry »
Posted in - Business... None of yours, - Did they REALLY say that?, - Do you feel like we do, Dr. Who?, - Lost In Space: TOTALLY Discombobulated | Tagged: Aetna, Brer Fox, Brer Rabbit, business, Cigna, Coventry Health Care, economy, enterprise, health, healthcare, Humana, insurance, Medicaid, Medicare, news, Obamacare, profitability, research, UnitedHealth Group, Wellpoint | Leave a Comment »
Posted by Warm Southern Breeze on Friday, October 5, 2012
It’s almost like trying to patch a roof while it’s leaking.
This Week in Alabama Politics
By Steve Flowers
It is basic public policy that you either have to raise taxes or reduce government services. It has become a cardinal sin in Republican politics to even say the word tax much less enact any increase in revenue. Our legislature is now overwhelmingly Republican and they are real Republicans. They take their no new tax pledge seriously as does our Republican governor. Therefore, when the dicing and crafting of the 2013 budget was being processed, new revenue enhancement measures were not on the table. It is doubtful that you will see any tax increase proposals anytime soon in the Heart of Dixie.
The state’s new budget year begins this week. It will be horrendous. There are draconian cuts to basic state services. Alabama has a constitutional amendment that mandates a balanced budget. We are in dire straits but at least we are not deficit spending like other states. California is teetering on bankruptcy.
This past year’s budget was bad. Teachers and state employees pay was cut this time last year. However, if you think that last year was bad, you ain’t seen nothing yet. This is the year that the chickens have finally come home to roost. The federal stimulus manna from Heaven has provided a lifeline salvation for several years but those dollars are gone. This fiscal year may well be the worst dilemma since the Great Depression.
My contention is that it is worse than the Depression years. During that era the state Read the rest of this entry »
Posted in - Politics... that "dirty" little "game" that first begins in the home. | Tagged: AARP, AL, Alabama, Alabama Medicaid, budget, disabled, elderly, GOP, governance, government, Great Depression, health, healthcare, Home Care, Home Health Care, Medicaid, Medicare, Nursing home, OpEd, policy, politics, Public policy, Republican, Republicans, Steve Flowers, tax, Taxation, taxes, United States, Welfare | Leave a Comment »
Posted by Warm Southern Breeze on Wednesday, September 26, 2012
Recollecting, one of my patients was similarly diagnosed, suffering terminal lung cancer of the small cell carcinoma type, and had one lung removed. He had presented to the ED (Emergency Department) with extreme hypoxia (lack of oxygen), to such an extent that his lips had a distinctive blue cast to them. His oxygenation was so exceedingly poor, that he would turn in bed, and his sats (oxygen saturation level) would drop to 70% – neither a good, nor one that would sustain life.
In conversation with him, I asked him what he wanted to have happen to him, how he wanted things to turn out for him. He wasn’t under any misguided notion about his state of well-being or health and wanted to depart the ICU.
He said, “I want to go home to die.”
I responded by saying, “We want you to go home too. Let’s see what we can do to get you back there.” At that point, I began some very simple teaching about his breathing. He was a habitual mouth breather, and he knew it. I’d glance up at him, and his mouth would be gaping open as he watched teevee. Problem was, that every time his mouth opened, his sats dropped, even though he was receiving high flow O2 therapy via specialized nasal cannula.
So I instructed him that by keeping his mouth closed and breathing through his nose, his sats would increase. And barring any other unforeseen circumstance, were his sats to consistently maintain above 90%, that would be the greatest step toward his objective to go home.
At the end of my shift, he was consistently satting 98%.
Doctors are practicing irrational medicine at the end of life
by Monica Williams-Murphy, MD on September 22nd, 2012, in Physician
I just took care of a precious little lady, Ms. King (not her real name), who reminded me that, too often, we doctors are practicing irrational medicine at the end of life. We are like cows walking mindlessly in the same paths; only because we have always done things the same way, never questioning ourselves. What I mean is that we are often too focused on using our routine pills and procedures used to address abnormal lab values or abnormal organ function, to rightly perceive what might be best for the whole person, or even what may no longer be needed. Our typical practice habits may in fact become inappropriate medical practiceat life’s end.Ms. King was a case in point: She was a 92-year-old nursing homepatient on hospice for metastatic breast cancer. Ms King had been transferred to the ER for a sudden drop in blood sugar, presumably due to her oral diabetes medication. Her appetite had apparently been trailing off, as is common at the end of life, and her medication appeared to have become “too strong.” Her glucose level had been corrected by EMS during her trip from the nursing home to the Hospital, so when I came into see Ms King she was at her ‘baseline.’I opened the door to bed 24 and a grinning little white-haired lady peered at me from over her sheet. “Hi,” she said greeting me first.“Hi, Ms King,” I smiled back at her and picked up her hand.
She reached over with her free hand to pat me on my forearm, “You sure are a cute little doctor,” she said smiling.
I couldn’t hold back a little laughter. “Well, you sure are a cute patient too,” I smiled and winked at her.
She winked back at me.
“Wow, this is the most pleasant 90-year-old I have cared for in a while,” I thought to myself.
As we chatted it became clear to me that she had some mild dementia but had no pain or complaints at the time. She just said, “I think I had a ‘spell’” ( a “Southernism” for some type of unusual and undefined episode of feeling ill or fainting); and “I’m not hungry” when I offered her food.
Leaving her room still smiling after our pleasant exchange, I went back to look at her medical record from the nursing home and two things immediately struck me: Read the rest of this entry »
Posted in - Do you feel like we do, Dr. Who?, - Faith, Religion, Goodness - What is the Soul of a man? | Tagged: blog, Cardiopulmonary resuscitation, care, Centers for Medicare and Medicaid Services, Data Formats, doctor, Emergency Department, End-of-life care, ER (TV series), family, health, healthcare, home, Home Care, home health, Hospice, HTML, ICU, Intensive care unit, KevinMD, king, Life support, loved ones, Markup Languages, Medicaid, Medical School, Medicare, medicin, medicine, news, Nurse, Nursing home, palliative, palliative care, physician, practitioner, twitter, Web Design and Development | Leave a Comment »
Posted by Warm Southern Breeze on Saturday, September 8, 2012
A few points for the reader to consider:
This fraud was national in scope, involving a $3 BILLION settlement, of which the North Carolina Attorney General was able to recoup $31.8M. Pfizer, Abbott, Johnson & Johnson, Forest Labs, Eli Lilly, Astrazeneca have also all plead guilty to deceptive and fraudulent marketing. It’s very likely a drop in the bucket in comparison with the greater scope.
The four most expensive Pharmacy frauds in the United States history have occurred since George W. Bush oversaw the rewriting of the Medicare Part D drug benefit in 2003. In order of their value, they are:
GlaxoSmithKline – $3 Billion, 2012
Pfizer – $2.3 Billion, 2009
Abbott Laboratories – $1.5 Billion, 2012
Eli Lilly – $1.4 Billion, 2009
The so-called “doughnut hole” in the Medicare prescription Part D drug plan was closed by President Obama. That “doughnut hole” was created under the George W. Bush administration, who caved in to lobbyists from BIG PHARMA, and allowed them to write much of that aspect of the 2003 revision of the Medicare Part D law (also known as the Medicare Prescription Drug, Improvement, and Modernization Act (MMA), and refused to allow Medicaid the opportunity to bargain for prices with pharmaceutical firms.
Advertising is expensive. Advertising for medications on television, radio, Internet, magazines, billboards, buses, and any other place where advertising is sold, is illegal in some nations. It was once illegal in the United States, until the 1980′s when the FDA OK’d it under pressure from the Reagan administration.
IMS Health, a medical data firm, calculates that drug companies’ business in the United States alone earns more than $300 billion a year.
Last year, GSK had $20 Billion gross profits on $27 Billion in revenue. So don’t let anyone EVER fool you into believing that drug companies don’t make enough money, don’t have enough profits, or enough profit margin.
Pharmaceutical companies spent Read the rest of this entry »
Posted in - Politics... that "dirty" little "game" that first begins in the home., - Read 'em and weep: The Daily News | Tagged: abuse, BIG MONEY, Big Pharma, Bupropion, corruption, FDA, Food and Drug Administration, fraud, George W. Bush, GlaxoSmithKline, GOP, lobbyist, Medicaid, North Carolina, Paroxetine, Paxil, Political corruption, Republican, Ronald Reagan, Roy Cooper, United States, waste, wealth, Wellbutrin | Leave a Comment »
Posted by Warm Southern Breeze on Wednesday, August 29, 2012
Not only does Governor Bentley send another man out to do his work, but he steadfastly refuses to do the right thing.
And the Huntsville Times REFUSES to cover Dr. Don Williamson’s stumping-for-the-governor’s “Let me borrow-nearly-a-half-BILLION-dollars-without-a-repayment-plan” appearance at City Hall.
Remember: Whatever you do,
• DO NOT increase tax rates on the wealthiest Alabamians, who already pay a lower rate than the impoverished – who also pay the 3d highest tax rate in the USA (why, even former Republican Governor Bob Riley called for tax change saying, “It is immoral to charge somebody making $5,000 an income tax.”);
• DO NOT increase property tax rates on corporate timber landowners who pay a lower rate than homeowners – who already pay 66% less than the national average;
• DO NOT increase severance tax rates on big oil & gas companies who are extracting those natural resources from under Alabama soil; and for goodness sake, whatever you do,
• DO NOT stop earmarking 9 out of every $10 of state tax revenue. God – and Governing Magazine – knows that our 50th place rank among our nation’s 50 states for fiscal management is as best as the whole state of retards can do.
Face it, folks. Alabama continues to be anally gang-raped by dogdamn retards, who call themselves “politicians.”
And, sadly enough, we apparently like it.
Medicaid crisis if Sept. 18 vote fails, state’s chief medical officer says
Written by Bob Johnson, Associated Press
3:11 AM, Aug. 27, 2012
Dr. Don Williamson, State Health Officer with the Alabama Department of Public Health, announces an emergency ruling that two dangerous chemicals marketed as ‘bath salts’ are being added to the Alabama Controlled Substances List during a press conference in Montgomery, Ala., on Tuesday, Feb. 22, 2011. (Montgomery Advertiser, Lloyd Gallman) / Advertiser file
Alabama’s chief public health official said Medicaid will be in deep trouble if voters do not approve a Sept. 18 referendum to take more than $437 million from a state trust fund and use it to prevent huge cuts in spending on state programs for three years.
The constitutional amendment, if approved by voters, would take $145.8 million a year for three years out of the Alabama Trust Fund to help balance the budget during a time when tax collections are expected to see little growth.
Some critics say the Alabama Trust Fund was initially set up more than 30 years ago to prevent state officials from raiding oil and gas revenue every time the state has a funding crisis.
State Health Officer Don Williamson, who is temporarily overseeing funding for Alabama’s health care program for the poor, said without receiving money from the trust fund the Medicaid program would be $100 million in the red.
He said this could jeopardize programs that provide medicine for poor patients, reduce payments for doctors who treat Medicaid patients, send more poor patients to emergency rooms and eliminate optional Medicaid programs such as providing life-saving dialysis treatment.
“These are life-threatening choices,” Williamson said.
Williamson told The Associated Press that Read the rest of this entry »
Posted in - Did they REALLY say that?, - Politics... that "dirty" little "game" that first begins in the home., - Read 'em and weep: The Daily News | Tagged: Alabama, Associated Press, Bob Riley, classes, Constitutional amendment, ding dongs, Don Williamson, fiscal, Fob James, fools, GOP, Govenor Bentley, governance, government, Great Depression, Huntsville -Behind The- Times, Huntsville Times, idiots, Medicaid, policy, politics, Republican, Republican stupidity, Robert Bentley, tax, Trust law, United States | Leave a Comment »
Posted by Warm Southern Breeze on Wednesday, August 29, 2012
The truth speaks for itself.—
Is Obamacare a Government Takeover of Medicine?
Carolyn McClanahan, Contributor
Physician/Financial Planner. I discuss all things money and medicine.
8/28/2012 @ 10:32PM
The purpose of this blog is to educate non-policy wonks on the content of the Affordable Care Act, discuss the practical logistics of how the law will be implemented, and share my perspective on potential “good” and “bad” of the law. The law is far from perfect, but it is the most significant attempt our country has ever made at reforming our costly and inefficient health care system. In case you are a reader who thinks the entire law is “bad,” I implore you to learn about the ten sections of the law in this previous post.
In addition to speaking gigs, I also do “talk radio” about once a month. The questions I’m asked give some indication of where education on the ACA is lacking. One refrain I’ve heard over and over is that Obamacare is a “government takeover” of medicine. This post explores that concept.
“Government takeover” fears seem to take on several different variations.
• Medicine will be a government run entity – doctors will be employed by the government and care will be paid for by the government.
• All of the doctors will be employed by the government, but insurance companies will still exist.
• The government will dictate what doctors can and cannot do.
• The government will make it so onerous to practice medicine that everyone will quit.
• If the government has one iota of involvement in any form, it is a government takeover.
So what really happens with the Affordable Care Act? Read the rest of this entry »
Posted in - Did they REALLY say that?, - Do you feel like we do, Dr. Who?, - Politics... that "dirty" little "game" that first begins in the home. | Tagged: ACA, Affordable Care Act, health, health care, health insurance, healthcare, insurance, Medicaid, Medicare, Obamacare, Patient Protection and Affordable Care Act, PPACA, United States, Wikipedia | Leave a Comment »
Posted by Warm Southern Breeze on Sunday, August 5, 2012
Many states and individuals complain about budget items, but few ever discuss the booming private prison industry in this nation – a Wall Street-traded for-profit prison system supported by tax dollars… a corporate welfare program if ever there was one.
A key paragraph is this one: “Although states spend significant amounts of money on criminal justice—it’s second only to Medicaid in state budgets—the vast majority of those costs go toward prisons, with limited emphasis on preparing prisoners for life on the outside. The costs of incarceration include an annual $82 billion spent on corrections nationwide, including millions for oversight of parole systems overseeing the 75% of prisoners released short of their full sentences.”
From Prison to a Paycheck
Instead of training and counseling, Newark is trying work first—with promising results
Former inmate Hector Morales at work; the Office of Reentry in Newark, N.J., intervened to help him. He says he was tired of being a bad role model for his kids.
Hector Morales might not seem, at first, to be an American success story. At age 50, he works the graveyard shift—7 p.m. to 5 a.m.—at the back of a garbage truck, part of a three-man crew that lifts and loads 80,000 pounds of waste each night in New York City. It’s his first job in years. The native of Paterson, N.J., a high-school dropout, still owes more than $9,000 in child-support payments to the state of New Jersey.
Former inmate Hector Morales at work; the Office of Reentry in Newark, N.J., intervened to help him. He says he was tired of being a bad role model for his kids. Katie Orlinsky for The Wall Street Journal
But compared with Mr. Morales’s situation a year ago, his story is a success.
Then, he was completing a five-year sentence at the Northern State Prison in Newark, N.J. The former heroin addict has spent, by his own estimate, 18 years behind bars, mostly on drug-related charges. Today, Newark-based Action Carting, one of the largest commercial disposal firms operating in New York, considers Mr. Morales to be a model employee and a good prospect for promotion if he completes his plan to get a commercial truck driver’s license. Currently, he’s on track to earn more than $60,000 a year, including overtime. Every week, part of his check goes to pay off his child-support debt.
Part of the change is due to Mr. Morales’s own attitude. “I got tired of being in jail, tired of officers controlling my life, tired of being the wrong kind of role model for my children,” he says.
His success says much about an unusual intervention by Newark. In April 2009, with the help of Read the rest of this entry »
Posted in - Faith, Religion, Goodness - What is the Soul of a man?, - Read 'em and weep: The Daily News | Tagged: Criminal justice, economy, employment, labor, Medicaid, New Jersey, New York, New York City, Newark, Newark New Jersey, news, Northern State Prison, prison, rehabilitation, United States, work | Leave a Comment »
Posted by Warm Southern Breeze on Monday, April 2, 2012
Today, I had remarked to long-time friend that, “I sure hope we get socialized medicine in the United States soon.“
I had reflected upon the thousands – literally thousands – of people I’ve seen needlessly stuffed away in Nursing Homes with no family member to love them, and the injuries and emotional insults they suffer as a result.
I continued and said, “The reason most folks send a parent or loved one to a Nursing Home is because Read the rest of this entry »
Posted in - Faith, Religion, Goodness - What is the Soul of a man? | Tagged: Arizona, Bedsore, Elder, Elderly care, family, Florida, Grandparent, health, Home Care, law, Medicaid, Medicare, Nursing, Nursing home, Parent, patient, United States, Violence and Abuse, Wrongful death claim | Leave a Comment »
Posted by Warm Southern Breeze on Saturday, March 31, 2012
I won the Alabama Lottery, and all I got was this lousy governor and inept Republican legislature.
His official state of Alabama web page states, “After one year in office, Governor Bentley still does not accept a salary – and still works to put Alabamians back to work. And it seems to be working.”
“Seems to be working”?
Oh, come on!
Across America, unemployment rates are generally lowering. Lower unemployment rates in Alabama is not because of anything this governor or legislature has done.
Here’s another example of their ineptitude.
An official state news releases on 21 March 2012 read Governor’s Mansion Doors to Read the rest of this entry »
Posted in - Did they REALLY say that?, - My Hometown is the sweetest place I know, - Politics... that "dirty" little "game" that first begins in the home. | Tagged: Alabama, Bentley, List of Governors of Alabama, Medicaid, Mullins, Republican, Robert Bentley, Robert J. Bentley | Leave a Comment »
Posted by Warm Southern Breeze on Wednesday, March 28, 2012
Naysayers, conservative political pundits and Obama “haters” of all stripe – Radical Republicans, TEA Partiers, White Supremacists, Neo Nazis, et al – have vilified and unified against already-enacted federal legislation that foremost, regulates practices by the Health Insurance industry, such as denial of coverage for children born with certain health conditions, denial of coverage for women with breast cancer, cancelling coverage in the midst of medical treatment, exorbitantly raising premium rates without actuarial justification, denying payment for covered services deemed medically necessary and rendered by qualified physicians or others, and more.
Such practices have been rightly demonized and justly described as onerous by almost everyone, even by the most staunch conservatives. So it remains a great mystery why so many are seemingly straining against what they denigrate as “ObamaCare.”
At least two elements of the law – the so-called Read the rest of this entry »
Posted in - Uncategorized | Tagged: American Bar Association, Anti-Injunction Act, Barack Obama, Financial Services, Florida, health insurance, Individual mandate, insurance, law, Medicaid, news, Obama, Obamacare, observations, Patient Protection & Affordable Care Act, Patient Protection and Affordable Care Act, United States, United States Department of Health and Human Services, United States Supreme Court | Leave a Comment »
Posted by Warm Southern Breeze on Tuesday, March 27, 2012
As I’m writing, the Supreme Court of the United States (SCOTUS) has concluded Day 2 of oral argument in the unprecedented three days of arguments on the Patient Protection and Affordable Care Act (PPACA).
Hear the oral argument Read the rest of this entry »
Posted in - Did they REALLY say that?, - Faith, Religion, Goodness - What is the Soul of a man?, - Politics... that "dirty" little "game" that first begins in the home. | Tagged: Affordable Care Act, Antonin Scalia, Florida, Individual mandate, Medicaid, Obamacare, Oral argument in the United States, Patient Protection & Affordable Care Act, SCOTUS, Supreme Court, United States, United States Department of Health and Human Services, United States Supreme Court | 4 Comments »