Alabama Governor Bentley signs Executive Order No.4 Creating Alabama Health Care Improvement Task Force

Yesterday, Monday, April 6, 2015, Alabama Governor Robert J. Bentley, MD signed Executive Order No.4 creating a 38-member “Alabama Health Care Improvement Task Force.”

Though the unspoken ostensible purpose of the task force is to likely make recommendations to the Governor for the expansion of Medicaid in Alabama, it’s being couched to the less-than-observant (or less-than-smart, take your pick), as a home-grown alternative to the big bad wolf of D.C. known as “ObamaCare.”

Again, for the benefit of the uneducated, in addition to decreasing fraud, waste and abuse, increasing efficiency, eliminating discrimination against women, children & people with “pre-existing” conditions, mandating numerous improvements to the quality of the delivery of healthcare from all states in order to receive payment (performance-based payment), the Patient Protection and Affordable Care Act (sometimes abbreviated as ACA, though popularly known as “ObamaCare”), contains a provision encouraging (but not requiring – that decision was made the U.S. Supreme Court) the state’s governors to expand Medicaid for their impoverished residents. The law provides for 100% payment for so doing, then gradually declines to 90%.

Governors in Kentucky and Arkansas have decided to Expand Medicaid in their states, and are already enjoying savings.

Currently, Alabama’s matching portion (the %age it pays to purchase Medicaid) is 32.4%; so to expand Medicaid, and have it ALL paid for, and then to pay a LOWER rate than is presently being paid is one of the smartest fiscal decisions the state could make.

Already, the Governors of Kentucky and Arkansas – both well-known Republican strongholds, with opposition to the ACA – have expanded Medicaid in their states, and are already reaping the rewards.

Here’s a chart showing the compensation plan to the states:

GAO Report: Pentagon spending out of control – Rumsfeld reported same in 2001

[UPDATE – Friday, September 4, 2020: The DOD link for SECDEF Rumsfeld’s remarks “DOD Acquisition and Logistics Excellence Week Kickoff — Bureaucracy to Battlefield” made Monday, September 10, 2001 has been relocated/obfuscated/archived. The PDF file of his remarks may now be found on/downloaded from this site, on Donald Rumsfeld’s archival site, or from the Homeland Security Digital Library, a site “sponsored by the U.S. Department of Homeland Security’s National Preparedness Directorate, FEMA and the Naval Postgraduate School Center for Homeland Defense and Security.” Ed.]

• SECDEF Donald Rumsfeld remarks Monday September 10 2001 DOD Acquisition and Logistics Excellence Week Kickoff — Bureaucracy to Battlefield,

• http://library.rumsfeld.com/doclib/sp/115/Remarks%20Launching%20DoD%20Acquisition%20and%20Logistics%20Excellence%20Week%2009-10-2001.pdf#search=%22pentagon%20bureaucracy%22 ,

• or https://www.hsdl.org/?view&did=2423 . Ed.]

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What does Alabama U.S. Senator Jeff Sessions think about the March 2012 Government Accountability Office report to Congress that found the 96 highest-priority defense programs in the Pentagon acquisitions system represented an estimated total cost of $1.58 trillion, and had actually “grown by over $74 billion or 5 percent in the past year”?

The report, entitled DEFENSE ACQUISITIONS: Assessments of Selected Weapon Programs – may be downloaded from the GAO website: http://www.gao.gov/assets/590/589695.pdf

Or from this blog internally: GAO 3/12 report – DEFENSE ACQUISITIONS Assessments of Selected Weapon Programs

And then, there are the Remarks as Delivered by Secretary of Defense Donald H. Rumsfeld, The Pentagon, Monday, September 10, 2001 entitled “DOD Acquisition and Logistics Excellence Week Kickoff — Bureaucracy to Battlefield,” in which he said “According to some estimates, we cannot track $2.3 trillion in transactions.”

How many variety of voices over an extended period of time do we need before we heed their warnings?

His speech, in its entirety follows.

More evidence that Government $pending boo$t$ economy

Recollect the brouhaha over Vice President Joe Biden‘s remark Thursday, July 16, 2009 in Alexandria, Virginia?

He was speaking at an AARP-sponsored town hall meeting also attended by AARP CEO A. Barry Rand, Health and Human Services Secretary Kathleen Sebelius and Nancy Ann DeParle, Director of the White House Office of Health Reform.

Vice President Biden said, “Now people, when I say that, look at me and say, ‘What are you talking about, Joe? You’re telling me we have to go spend money to keep from going bankrupt?’ The answer is ‘yes,’ that’s what I’m telling you.”

{ref: http://cnsnews.com/node/51162}

“And folks look, AARP knows – and the people with me here today know, the president knows, and I know – that the status quo is simply not acceptable. Its totally unacceptable. And its completely unsustainable. Even if we wanted to keep it the way we have it now. It can’t do it financially, Were going to go bankrupt as a nation. Now, people when I say that look at me and say, ‘What are you talking about, Joe? You’re telling me we have to go spend money to keep from going bankrupt?’ The answer is ‘yes,’ I’m telling you.”

Of course, Vice President Biden was speaking in context of the Affordable Care Act – also commonly known as “ObamaCare” – which the Government Accountability Office has shown has already demonstrated significant cost savings and proven to be business-stimulating legislation, and that to eliminate it’s protections would cost the federal government even more in the long-term.

Analogously, it’d be like having a fuel inefficient automobile – one that only got about 5 miles/gallon, or less. If you were to purchase even a used vehicle with twice the fuel economy – 10mpg – you could realize significant overall long-term savings. Simply ceasing driving will not solve any problem, but would rather create more problems.

Similarly, could you imagine having an inefficient Heating/Ventilation & Air Conditioning (HVAC) system? You gotta’ stay cool in the summer and warm in the winter – there’s no way around it. And to lower your average monthly utility bills by even 1/3 would be beneficial.

So, here’s a shocker for armchair philosophers, political pundits, amateur economists, Radical Republicans, TEA Party types and more: Government spending – in part – is a significant driver of our nation’s economy. And, spending on economic infrastructure is ALWAYS a most wise investment.

Why?

Because 1.) Materials and Manpower ALWAYS come from the PRIVATE SECTOR, and;

A: 1.4% Q: What is the annualized spending growth rate under Obama & lowest rate of any president since Reagan?

Who’s the Biggest Spender? Obama or Bush?

By BRUCE BARTLETT, The Fiscal Times June 1, 2012

Lately, there has been some controversy about the growth of spending under Barack Obama. It began on May 22 with a column by Rex Nutting of MarketWatch, which concluded that the rate of growth of federal spending under Obama has actually been trivial compared to the last 4 presidents.

According to Nutting’s calculations, spending has grown only 1.4 percent per year under Obama – one-fifth the rate under Ronald Reagan and George W. Bush. Following is a chart accompanying the article.

There has been a considerable amount of debate about Nutting’s calculations, which fly in the face of Republican dogma. Much involves technical accounting issues, such as how to allocate spending during fiscal year 2009. This is important because fiscal year 2009 began on September 1, 2008 during Bush’s administration, reflecting his priorities. By the time Obama took office on January 20, 2009 the fiscal year was almost half over; he didn’t submit his first budget until February 26, 2009 and the fiscal year 2010 budget is really the first one that reflected his priorities.

Nutting assigned the bulk of fiscal year 2009 spending to Bush, an assumption that other analysts have questioned. Glenn Kessler of the Washington Post found that Nutting overstated his argument in various ways. But the PoliFact site of the Tampa Bay Times concluded that the Nutting column was essentially correct.

Aside from the political implications, the reason this debate is important is because there is a tendency for people to conflate spending, deficits and debt, as well as confusing rates of change with absolute levels.

The difference between

GAO IDs Billion$ in federal wa$te

In a recently released report, the Government Accountability Office (formerly known as the Government Accounting Office), has identified Billions of dollars of waste in federal programs, many of which are described as “duplication, overlap, or fragmentation could potentially save billions of taxpayer dollars annually and help agencies provide more efficient and effective services.”

Oklahoma Senator Tom Coburn (R), said that by implementing the suggested changes – such as through consolidation, “We could save taxpayers hundreds of billions of dollars every year without cutting services.”

Some examples of streamlining include consolidating responsibilities within agencies, such as with catfish, for example. The United States Department of Agriculture (USDA) has responsibility for monitoring catfish, while the Food and Drug Administration (FDA) also has responsibility for oversight of the seafood industry. As well,

Alabama’s Certificate of Need Law

Wow!

With what I know about Alabama’s CON law, I could write volumes! And then, the title’s enough to get me started. I decided to use the “KISS” principle – Keep It Simple, Stupid.

If you’re a follower of Alabama politics – even casually – then you most likely have heard of, or remember former Governor Don Siegelman and former HealthSouth CEO Richard Scrushy being convicted jointly of a “quid pro quo,” or more exactly, Siegelman was accused of accepting Scrushy’s bribe… to sit on the CON Board.

Never mind that the FBI extensively coached a known perjurer about what and how to testify – itself an illegal act – and never mind that Scrushy was appointed by two governors of two different parties to sit on the CON Board, and publicly expressed disdain for serving again. But that’s all water under the bridge. I only mentioned that because of its poignancy, and is relative to this post.

I sincerely doubt that most folks know that in Alabama, at least, not just anyone, or any organization can decide to build a hospital. For example, if Warren Buffett and Bill Gates decided that together, they wanted to gift the good people of Alabama with a hospital, they could NOT do it.

Why?

Read on to find out!