Is It TRUE -or- Is It FALSE?

True -or- False?

1.) Approximately 70% of adult wage earners in households that received SNAP (Supplemental Nutritional Assistance Program, formerly known as “Food Stamps”) and/or Medicaid worked full time hours (defined as 35+ hours weekly), and about 50% worked full time hours yearly.

2.) 90% of wage-earning adults participating in either SNAP or Medicaid worked in the Private Sector, compared to 81% of non-participants.

3.) When compared to adult wage earners not participating in SNAP or Medicaid, wage-earning adults in either or both programs were more likely to work in the Leisure and Hospitality industry, and in Food Service occupations.

4.) The single largest majority of adult wage earners who participated in SNAP and/or Medicaid worked for employers with

We Can Do Better

Dorothea Lange. “Nipomo, Calif. March 1936. Migrant agricultural worker’s family.
Seven hungry children and their mother, aged 32. The father is a native Californian.” Gelatin silver print, 7 3/8 × 9 5/16″ (18.8 × 23.6cm). Farm Security Administration–Office of War Information Photograph Collection, Library of Congress

Hourly Wages
Dollar General: $8
Kroger: $10
Walmart: $11
CVS: $11
Home Depot: $11
Lowe’s: $12

2020 Profits
Dollar General: $1.4 billion
Kroger: $2 billion
Walmart: $15.6 billion
CVS: $6.2 billion
Home Depot: $10 billion
Lowe’s: $4.9 billion

U.S. workers need at least $15/hr and a union.

Per capita health care spending:
Norway: $6,647
United States: $11,072

Number of uninsured/under-insured:
Norway: 0
United States: 92 million

COVID-19 deaths:
Norway (population 5.3 million): 306
Louisiana (population 4.6 million): 6,260

Yes. It is time for Medicare for All.

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https://www.WashingtonPost.com/business/2020/11/18/food-stamps-medicaid-mcdonalds-walmart-bernie-sanders/

Federal Study: Millions of Full-Time Workers Rely on Federal Health Care and Food Assistance Programs – Walmart’s and McDonald’s Employees Lead the Way

by Eli Rosenberg
November 18, 2020 at 5:02 p.m. CST

Some of the biggest and most profitable companies in the United States, including Walmart and McDonald’s, pay their employees such low wages that significant numbers of them must turn to Federal food and medical assistance.

According to a new report from the Government Accountability Office, a nonpartisan Congressional watchdog agency, made at the behest of Sen. Bernie Sanders (I-Vermont) there is a direct relationship between employers paying low wages and employees receiving the Federal assistance. The report examined February data from agencies in 11 states that administer the Federal programs Medicaid, and the Supplemental Nutrition Assistance Program (SNAP).

Walmart was one of the top four employers of SNAP and Medicaid beneficiaries in every state. McDonald’s was in the top 5 of employers with employees receiving federal benefits in at least 9 states.

The GAO research found that in the 9 states that responded about SNAP benefits — Arkansas, Georgia, Indiana, Maine, Massachusetts, Nebraska, North Carolina, Tennessee and Washington — Walmart was found to have employed about 14,500 people who were receiving benefits, followed by McDonald’s with 8,780. In six states that reported Medicaid enrollees, Walmart again topped the list, with 10,350 employees, followed by McDonald’s with 4,600.

In Georgia, for example, Walmart employed an estimated 3,959 workers who were on Medicaid — comprising an estimated 2.1% of the total of non-elderly, non-disabled people in the state who were receiving the benefit. McDonald’s was next on the list, employing 1,480 who received Medicaid, or 0.8% of the total of non-elderly, non-disabled people on the program.

In Oklahoma, 1,059 Walmart workers on Medicaid made up 2.8% of the state’s total, and McDonald’s was next, with 536 workers, or 1.4%.

In Arkansas, where Walmart was founded and maintains its global headquarters, 1,318 employees were receiving SNAP benefits — comprising 3.1% of the state’s total. McDonald’s was next on the list with 865 workers, which made for 2% of the state’s total.  And in Georgia, another 3% of SNAP recipients worked for Walmart.

The GAO report found that the next companies with large numbers of workers receiving federal benefits included Dollar Tree, Dollar General, Amazon, Burger King and FedEx. (Amazon Chief Executive Jeff Bezos owns The Washington Post.)

In a statement by McDonald’s spokeswoman Morgan O’Marra, the company claimed

#ALpolitics could STILL $ave money if they were to #ExpandMedicaid

Alabama, among other states, should have expanded Medicaid when they had the opportunity to do so, and with SIGNIFICANT REWARD! In other words, at the very first. Now, if any state decides to expand Medicaid, there’s little, if any, incentive, except that there will be some savings to the state, and benefit to their citizens, by having access to healthcare.

A sick workforce can’t survive.

The Centers for Disease Control and Prevention (CDC) continually tell America that the sickest, the fattest, the most diabetic, the most smokers, and cancer-ridden, are in the Southeast… which largely voted for Trump, and has been predominately GOP-voting for at least the past 25+/- years. And I write of Alabama in particular.

In a November 2012 brief entitled “An Economic Evaluation of Medicaid Expansion In Alabama under the Affordable Care Act” by Professors Drs. David J.Becker, Ph.D.and Michael A. Morrisey, Ph.D of the University of Alabama at Birmingham School of Public Health, Lister Hill Center for Health Policy, they presented the case for the numerous potential benefits of expanding Medicaid in Alabama, which was not merely an improvement in the overall quality of life for Alabamians, but significant economic benefit to the entire state.

Drs. Morrisey and Becker are Professor and Director, and Assistant Professor, respectively, at the University of Alabama at Birmingham School of Public Health, Lister Hill Center for Health Policy, and have researched and written extensively the subject. The University of Alabama at Birmingham is one of three independent, autonomous universities in the UofA System.

Then-Governor Dr. Robert Bentley, MD, a Republican, was forced to resign in shame in the midst of his second term after pleading guilty to charges of corruption and ethics violations, and refused to expand Medicaid in “Sweet Home.”

The Bureau of Labor Statistics has most recently shown that employment in the Healthcare sector is thriving nationwide. The figures below are from the BLS’ most recent report “THE EMPLOYMENT SITUATION — MARCH 2018,” and is expressed in thousands. The columns in order, are: Not Seasonally Adjusted, March 2017, January, February, March 2018, and Seasonally Adjusted for the same times, respectively. (ESTABLISHMENT DATA Table B-1. Employees on nonfarm payrolls by industry sector and selected industry detail)

Drs. Morrisey and Becker identified that had then-Governor Bentley expanded Medicaid, a Federal/State program that pays healthcare costs for the impoverished, the state could have not merely eked it’s way out of recession, but it would have propelled itself in rocket-like fashion, to a position of economic strength and stamina.

They cited a provision in the Patient Protection and Affordable Care Act (ACA) which provided incentive to states to expand Medicaid by offering a one-time bonus of paying for 100% of all costs in 2014, followed by nominal reductions each year thereafter. And if states chose to expand Medicaid, they would have paid LESS (a smaller percentage) even after all incentives expired. Medicaid is a Federal-State sharing program in which the states bear a certain portion, while the Federal Government picks up the remaining share.

They wrote in part, that “Under the ACA, Alabama would receive a significantly higher Federal Matching Assistance Percentage (FMAP) for the expansion population than the 68.5% it currently receives for the non ‐ expansion population. The ACA provides for a uniform FMAP to all states of 100% in 2014 ‐ 2016, 95% in 2017, 94% in 2018, 93% in 2019 and 90% in all years thereafter.”

Presently, because Alabama has chosen to NOT expand Medicaid under the provisions of the ACA, they are STILL paying MORE for Medicaid than if they would have expanded it… even now, in 2018. That’s because the OLD law, under which the state labors, requires Alabama (and other states that did not expand Medicaid) to pay 31.5%. If Alabama would EXPAND Medicaid even now, in 2018, they would pay only 10%.

Governess Kay Ivey, also a Republican, who as Lt. Gov. assumed office following Bentley’s resignation after pleading guilty to corruption and ethics violation charges, has similarly expressed her reticence to expand Medicaid.

In 2016, Alabama spent $5,461,151,125 for Medicaid.

Noting that their “analysis does not consider potential savings from reduced spending on uncompensated care, mental health care and other services currently provided to the expansion population,” assuming the state expanded Medicaid and would pay “6.2% of program costs through 2020,” Drs. Morrisey and Becker projected three scenarios of a high, moderate, and low “take-up,” meaning enrollment into the program, and wrote that, “we estimate that the state of Alabama would be responsible for $771 million (6.2%) of the estimated $12.5 billion in new Medicaid program costs over the 2014 ‐ 2020 period,” and noted specifically, that “If more previously uninsured or privately insured individuals elect to enroll in Medicaid costs to the state and Federal government would rise. If take ‐ up were lower, the costs to the state and Federal government would fall.”

If Alabama had chosen to expand Medicaid in 2016 – the last year the Federal Government paid 100% of ALL COSTS of expansion – the state would have SAVED $5,461,151,125… the TOTAL cost of Medicaid. If Alabama were to expand Medicaid in 2018 (this year), they would pay only 6.2% of the costs, while the Federal Government would pay 93.8%. Using a high “take-up” scenario for 2018, Drs. Morrisey and Becker projected the state would pay $243,000,000… about 77.5% LESS than what it paid in 2016. A low “take-up” scenario for 2018 would be 46.48% lowered costs to the state.

The state has a peculiar and non-standard practice of having TWO budgets, the Education Trust Fund and General Fund budgets. Medicaid is paid from the General Fund budget, which is the smaller of the two, and receives “Taxes from over 40 sources are deposited into the GF, with the largest sources being the insurance company premium tax, interest on the Alabama Trust Fund and state deposits, oil and gas lease and production tax, cigarette tax, ad valorem tax, and Alabama Alcoholic Beverage Control Board profits,” and pays for and “supports state programs such as child development and protection, criminal justice, conservation efforts, economic development, public health and safety, mental health, Medicaid, legislative activities, and the court system.”

The much larger Education Trust Fund, receives revenue from “Ten tax sources are allocated to the ETF, the largest of which are the individual and corporate income tax, sales tax, utility tax, and use tax.” Revenues from the Education Trust Fund “support, maintenance and development of public education in Alabama, debt service and capital improvements relating to educational facilities, and other functions related to educating the state’s citizens. Programs and agencies supported by the ETF include K-12 education, public library services, performing and fine arts, various scholarship programs, the state’s education regulatory departments, and two- and four-year colleges and universities. Funding from the ETF is also provided to non-state agencies that provide educational services to the people of Alabama, including the arts, disease counseling and education, and youth development.”

Medicaid requires states to cover:
• Pregnant women up to at least 138% of the Federal Poverty Level (FPL) ($16,643 for an individual, $33,948 for a family of four in 2017)

• Preschool-age children up to at least 138% of the FPL ($16,643 for an individual, $33,948 for a family of four in 2017)

• School-age children up to at least 100% of the FPL ($12,060 for an individual, $24,600 for a family of four in 2017)

• Elderly and disabled individuals up to at least 75% of the FPL ($9,045 for an individual, $18,450 for a family of four in 2017)

• Working parents up to at least 28% of the FPL ($3,376 for an individual, $6,888 for a family of four in 2017)

Moreover, however, Alabama could have improved its economy by expanding Medicaid. In that same report, Drs. Morrisey and Becker considered three possible scenarios also based upon a high, moderate, and low “take-up” rate which showed that Alabama could have benefited between $2.331 billion and $33.529 billion in additional value added to the state’s economy from 2014-2020 (Low-to-High, inclusively and respectively).

They concluded that, using the intermediate, or moderate “take-up” scenario, “we project that a coverage expansion would reduce the state’s uninsured population by approximately 232,000 individuals while generating $20 billion in new economic activity and a $935 million increase in net state tax revenues.”

Again, that does NOT include the savings from eliminating uncompensated care.

Bottom line?

It would STILL be exceedingly wise for Alabama to expand Medicaid.

Mobile Alabama MD & Medical Practice Settle Medicare, Medicaid & TRICARE Fraud Claims

The Department of Justice, United States Attorney’s Office, Southern District, announced that Mobile, Alabama physician Dr. James Matthew Crumb, MD (AL license number MD.24535, AL Controlled Substances Certificate ACSC.245, National Provider Identifier: 1629079793 ) a Physical Medicine and Rehabilitative physician who currently practices as Mobility Metabolism and Wellness (MMW), and a local neurosurgeon group Coastal Neurological Institute, P.C. (CNI), 3280 Dauphin Street, Suite A, Mobile, AL 36606-4060, (NPI:1740212174), have collectively paid $1.4 million to settle allegations that they violated the False Claims Act (“FCA”) by engaging in fraudulent schemes to maximize payment from the Medicare, Medicaid, and TRICARE health care programs.

In late December 2015, the United States Attorney’s Office filed a civil lawsuit against Defendants CNI, Crumb, and MMW, on behalf of the Department of Health and Human Services and the Department of Defense, alleging that the Defendants knowingly billed federal health care programs for

Can We #RepealAndReplace #ObamaCare?

The Patient Protection and Affordable Care Act (PPACA, aka ACA, or more often as “ObamaCare”) might be analogized to an onion, insofar as:
1.) It has many layers, and;
2.) Peeling back the layers may cause tears.

Enacted in 2010, it has been decried primarily by Republicans, none of whom voted for the bill’s passage, either in the House, which approved it 219-212 with 34 Democrats voting “NO” – or in the Senate, which approved it 60-39 along party lines, with 1 Republican (Jim Bunning, KY) “Not Voting.”

The Patient Protection and Affordable Care Act contains nine titles, each addressing an essential component of reform:
1.) Quality, Affordable Health Care For All Americans
2.) The Role Of Public Programs
3.) Improving The Quality And Efficiency Of Health Care

4.) Prevention Of Chronic Disease And Improving Public Health
5.) Health Care Workforce
6.) Transparency And Program Integrity

7.) Improving Access To Innovative Medical Therapies
8.) Community Living Assistance Services And Supports
9.) Revenue Provisions

Immediate improvements through reform included:
• Eliminate lifetime and unreasonable annual limits on benefits
• Prohibit rescissions of health insurance policies
• Provide assistance for those who are uninsured because of a pre-existing condition

• Require coverage of preventive services and immunizations
• Extend dependent coverage up to age 26
• Develop uniform coverage documents so consumers can make apples to apples comparisons when shopping for health insurance

• Cap insurance company non-medical, administrative expenditures
• Ensure consumers have access to an effective appeals process and provide consumers a place to turn for assistance navigating the appeals process and accessing their coverage
• Create a temporary re-insurance program to support coverage for early retirees

• Establish an Internet portal to assist Americans in identifying coverage options
• Facilitate administrative simplification to lower health system costs

While no law is perfect – and the ACA is not perfect – there are provisions within it which many think worthy of keeping, notable among them, provisions for guaranteed coverage, prohibiting cancellation, extending dependent’s coverage, removing annual & lifetime limits,

How And Why Insurance Companies Control Your Medical Care

Some have accurately, and justifiably observed that the Affordable Care Act, also colloquially known as “ObamaCare,” is a big fat, sloppy wet kiss to the Big Insurance industry and their for-profit, Wall $treet corporate masters, because their profits have continued to soar since it’s inception. Note that UnitedHealth Group reported a profit of $11 billion (on revenues of more than $157 billion) in 2015, up from $10.3 billion (on revenues of $131 billion) in 2014. Consider also how Anthem’s business changed in just one recent year. At the end of 2014, the majority of Anthem’s revenues still came from its Commercial Health Insurance customers. During 2015, however, revenues from their commercial operations actually declined 4.2%, to $37.6 billion, while revenues from their government operations skyrocketed 21%, to $40.1 billion. A significant reason why, is because of the big investments Insurance Companies continue to make in House and Senate campaigns. As a result, the Insurance Industry’s tentacles will likely only get deeper into both the Medicare and Medicaid programs.

Medical equipment is pictured on the wall of an examination room inside a Kaiser Permanente health clinic located inside a Target retail department store in San Diego, California November 17, 2014. Four clinics are scheduled to open to provide pediatric and adolescent care, well-woman care, family planning, and management of chronic conditions like diabetes and high blood pressure for Kaiser members and non-members. REUTERS/Mike Blake (UNITED STATES – Tags: HEALTH BUSINESS SOCIETY) Fair Use

by Christy Ford Chapin

It’s that time of year again. Insurance companies that participate in the Affordable Care Act’s state health exchanges are signaling that prices will rise dramatically this fall.

And if insurance costs aren’t enough of a crisis, researchers are highlighting deficiencies in health care quality, such as unnecessary tests and procedures that cause patient harm, medical errors bred by disjointed or fragmented care and disparities in service distribution.

While critics emphasize the ACA’s shortcomings, cost and quality issues have long plagued the U.S. health care system. As my research demonstrates, we have these problems because insurance companies are at the center of the system, where they both finance and manage medical care.

If this system is so flawed, how did we get stuck with it in the first place?

Answer: Organized physicians.

As I explain in my book, “Ensuring America’s Health: The Public Creation of the Corporate Health Care System,” from the 1930s through the 1960s, the American Medical Association, the foremost professional organization for physicians, played a leading role in implementing the insurance company model.

What existed before health insurance companies?

Between the 1900s and the 1940s, patients flocked to what were called “prepaid physician groups,” or “prepaid doctor groups.”

Prepaid groups offered inexpensive health care because

UNC Chapel Hill Research: Medicaid Expansion Helps Rural Hospitals

As of the date of this posting – Monday, 19 September 2016 – there are 19 states which have NOT Expanded Medicaid, and Alabama is one of those 19.

In alphabetical order, they are:

Current Condition of Medicaid Expansion
Has YOUR state expanded Medicaid?
Orange=NO

1.) Alabama
2.) Florida
3.) Georgia
4.) Idaho
5.) Kansas
6.) Maine
7.) Mississippi
8.) Missouri
9.) Nebraska
10.) North Carolina
11.) Oklahoma
12.) South Carolina
13.) South Dakota
14.) Tennessee
15.) Texas
16.) Utah
17.) Virginia
18.) Wisconsin
19.) Wyoming

 

 

 

 

 

Lack Of Medicaid Expansion Hurts Rural Hospitals More Than Urban Facilities

By Shefali Luthra September 7, 2016

It isn’t news that in rural parts of the country, people have a harder time accessing good health care. But new evidence suggests opposition to a key part of the 2010 health overhaul could be adding to the gap.

The finding comes from a study published Wednesday in the journal Health Affairs, which analyzes how the states’ decisions on implementing the federal health law’s expansion of Medicaid, a federal-state insurance program for low-income people, may be influencing rural hospitals’ financial stability. Nineteen states opted not to join the expansion.

Rural hospitals have long argued they were hurt by the lack of Medicaid expansion, which leaves many of their patients without insurance coverage and strains the hospitals’ ability to better serve the public. The study suggests they have a point.

Specifically, the researchers, from the University of North Carolina Chapel Hill, found that

Why #ALpolitics Should’ve Elected @RonSparks2010 – @GovernorBentley In His Own Words: “I had no clue.”

Having made no bones about it, I remain searingly and scathingly critical of Alabama Governor Robert Julian Bentley, a retired physician-turned-Republican legislator from Tuscaloosa, who is twice elected governor – in 2010, and in 2014.

While I wished him well after his initial victory in the governor’s race against his Democratic opponent then-Secretary of Agriculture and Industries, Ron Sparks, he has disappointed the state since Inauguration Day 2011 when he put his foot in his mouth at Dexter Avenue King Memorial Baptist Church, Montgomery, where on Martin Luther King Day, Monday, January 17, 2011 – mere hours after taking the oath of office and inauguration – he said in part, “There may be some people here today who do not have living within them the Holy Spirit. But if you have been adopted in God’s family like I have, and like you have if you’re a Christian and if you’re saved, and the Holy Spirit lives within you just like the Holy Spirit lives within me, then you know what that makes? It makes you and me brothers. And it makes you and me brother and sister. Now I will have to say that, if we don’t have the same daddy, we’re not brothers and sisters. So anybody here today who has not accepted Jesus Christ as their savior, I’m telling you, you’re not my brother and you’re not my sister, and I want to be your brother.”

It was at that point that Rebekah Caldwell Mason became his Communication Director, and later, Senior Political Advisor-cum-paramour.

More to the point, however, I have maintained that among other things, as an elected official, he has been feckless, and clueless.

But, let’s let him speak for himself.

Here’s in part what Governor Bentley said in a speech to a statewide gathering of city officials in Montgomery, May 2013, “You know where I came up with that idea? Ron Sparks.

UPDATED: If #ALpolitics Would #ExpandMedicaidNow, They Could CUT Medicaid Co$t$ More Than 50%

UPDATE: Tuesday, 11 August 2015
CORRECTION ADDENDUM

In my first & earlier calculations, I inadvertently overlooked multiplying the Annual Medicaid Spending in Alabama figure (which is a TOTAL of $5,241,269,869) by 70%, which would represent the portion paid for by the Federal government. Alabama’s 30% share of that figure (the share paid for by the state) would be $1,572,380,960.70. It would also be reasonable to expect that Expanding Medicaid in Alabama to 138% of the Federal Poverty Level would increase total economic activity (through Medicaid spending) in the state at least 38%. So to Expand Medicaid, the baseline figure for TOTAL Medicaid spending (combined Federal and State funds) would approximate $7,232,952,419. According to the provisions of the law, Alabama’s sharing portion (if Governor Bentley chose to Expand Medicaid) would still be 2016-100%; 2017-5%; 2018-6%; 2019-7%; 2020 and beyond-10%. The corrections to the figures herein are dollar amounts only (based on the $7,232,952,419 total expanded figure), not the %ages. Data & figures are now also shown in table format.

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Folks, it may (or may not) surprise you to know a sampling of the collective thoughts of our wrong-wing friends, and relatives on matters political in Alabama, especially as they pertain to Medicaid.

Here’s a verbatim excerpted sampling of what I came across today.

• No one want increased entitlements. Too much waste and abuse. get a job folks. no to medicaid
• Medicaid is a lifestyle
• scare tactic. nursing homes overcharge. working people of Alabama are tired of taking care of lazy people
• ask any hospital administrator or physician in private practice. Medicaid devalues services. Reject medicaid

I dare say, MOST are clueless about the genuinely tangible economic and public health benefits Medicaid provides to this state, and the revenue and jobs it creates. All they hear are the wails and moans of representatives and/or senators – mostly of whom, if not exclusively, are Republican.

Where does Alabama’s Medicaid money come from?
Where does it go?
Source: Alabama Medicaid Agency Annual Report – FY 2012

Medicaid is a Federal/State matching/sharing program which provides (pays for) healthcare services for the impoverished wherein states pay a minority matching portion, while the Federal Government through CMS (Centers for Medicare and Medicaid Services) pays the majority portion. Within reasonable guidelines, the states have broad discretion and liberty to operate Medicaid according to the way they see fit, and the needs of the residents they serve. There are, however, certain minimums standards to which every state must adhere.

Under the provisions of the OLD law, the states that do NOT Expand Medicaid pay a higher %age rate for their services than they would if they were to Expand Medicaid to provide services to those whom are at 138% of the Federal Poverty guidelines – which is what the PPACA provides. The PPACA is the Patient Protection and Affordable Care Act- though it’s more often called the ACA “Affordable Care Act,” and colloquially referred to as “ObamaCare.”

Under the provisions of the PPACA, states that choose to Expand Medicaid will have 100% of those costs paid-for by the CMS beginning 2014, until 2016. The incentive for expansion is based upon

Reasons Why Ohio Governor John Kasich Will Be Our Next President

There are numerous reasons, actually.

Here are a few:

He has an excellent political background/pedigree/experience.
• In 1978, aged 26 he was elected to the Ohio State Senate’s 15th Senatorial District, and remains OH’s youngest ever elected state senator
• In 1982, he was elected to the US House of Representatives 12th Ohio District, where he served from ’83-2001 (was re-elected 8 times) by at least 64% each time
• In 2010, he was elected governor, and in 2014 re-elected in a landslide, carrying all but 2 counties (86/88) – including the traditionally Democratic-leaning Hamilton county, where Cincinnati is located

Ohio Governor John Kasich (2010 & 2014)

He has done quite well by Ohio voters.
• His approval rating (always fluctuating for any elected figure) among Ohioans, has been as much as 77%.
• He expanded Medicaid in Ohio (which reduces uncompensated care & increases hospitals’ solvency)
• He saved $3Billion in the Medicaid budget, and slowed growth in the plan from 9%-3%, the lowest rate nationally
• He used cost-saving reforms & turned a $6-8 Billion Ohio budget shortfall into a balanced budget without raising taxes
• During his first term as governor, he grew the “Rainy Day Fund” (surplus) from $890M-1.5B
• In his first budget, he implemented a Personal Income Tax cut
• In his second budget, he implemented a 10% Personal Income Tax cut, and a 50% Small Business Income Tax cut
• During his first term as governor, he created 316,800 new jobs, and the state Unemployment Rate fell from 9.4% to 5.1%
• Education funding is at the highest level it’s ever been
• Because of Criminal Justice reforms, Ohio’s recidivism rate (reoffending) of prisoners is the lowest in the nation
• He has vigorously worked

The Power of One Small Idea: How Alabama could hit a home run WITHOUT raising taxes in the budget crisis.

Creativity is in short supply in Monkeytown, Alabama.

I refer, of course, to Montgomery.

And to be certain, there is a backstory on the nickname.

Seems the Montgomery Zoo was originally located in Oak Park, and then named Oak Park Zoo. The zoo also had an island of monkeys, which once escaped. Hence, the nick name.

For what it’s worth, the Montgomery City Planetarium, formerly known as Gayle Planetarium, is also located in Oak Park. I encourage you to go there, sometime! I have.

But back to the creativity thing.

Alabama is in dire straits fiscally. But, then again, that’s nothing new. Governor Bentley has promised (and broken) numerous pledges in his first & second campaigns. The one bothering most folks is the “read my lips… no new taxes” promise he unwisely made while campaigning for a second term.

It may not be the lie the second time around, as much as it is the entire deception thing from the get-go. Because he, the AL GOP, and the entire Legislature knew all about this well in advance. They knew there would come a day when the monies they “borrowed” from the Alabama Trust Fund must be repaid. That day has come… and is now gone. They’re essentially reneging on their promise, which not only makes them liars, but thieves as well, since money is involved.

So, you’re damn skippy the people are hopping mad!

Again, to be certain, Alabama is in a

Alabama Politics: Just Another Day In Paradise

Opining upon the notion of Alabama State Senator Del Marsh’s casino gambling plan to fund Medicaid, someone wrote, “[It’s] The only voluntary tax I know of. If you don’t want to play don’t pay.”

The retort was, “I’m finding myself more open to this lately however; once someone loses their house, job, family etc., don’t come crying for taxpayers to take care of you.”

To which came this reply, “Those people are already finding ways to gamble their lives away. They don’t need a lottery.”

My response follows.

“Those people,” are the Legislators.

In this one thing, I share the Governor’s sentiment – which he ineffectually (no surprise there) communicates:

Lottery will NEVER remedy poor fiscal policy, with which Alabama is replete.

In almost every lottery situation, law demands that the proceeds from lottery are to be used to supplement – not supplant – existing revenue. And in this single instance authored by Senator Del Marsh (R, Anniston) it is being used to supplant – to replace – existing sources of revenue. And that is

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:

Like Jesus, I wept.

It was one of the few times I have wept over others’ misfortunes – especially my patients.

I went into a closet to weep very bitter tears.

The thought of others seeing me so heartbroken was unconscionable, one which I simply could not bear.

Why?

Open Letter to Alabama Governor Robert Bentley, MD

Open Letter to Governor Bentley
October 10, 2014 at 12:45pm

Governor Bentley,

I need to go to the doctor. But I can’t. For some reason I still can’t understand you turned down Federal money set aside for people like me.

On June 24, 2014, on my way to see a doctor to determine disability benefits, I had a car accident. My car was totaled and my lip busted. I had hit the steering wheel with my face.

I still almost refused the ambulance ride because I was afraid of the bill. It took a street full of people to convince me to go. I had my lip sewn up, some scans done. I was sent home with a neck brace.

I have $12,000 in bills now, and my disability was denied. I am more disabled now than before the accident. I am waiting on an appeal with no medical care and no income. That hospital bill will never get paid. I wonder how many other people in this state are in the same situation. Sometimes I think

“No, Dr. Bentley, we are in no way prepared for Ebola.”

Pippa Abston, MD, PhD, is considered by many, to be the preeminent, board-certified general pediatric physician in the Tennessee Valley, and is author of the following commentary, written in response to a news item entitled “Ebola hasn’t surfaced in Alabama but state ready, Gov. Bentley says,” published October 08, 2014 at 9:03 AM, updated October 08, 2014 at 12:59 PM at http://www.al.com/news/index.ssf/2014/10/gov_robert_bentley_on_ebola_vi.html.

In his press conference, Governor Bentley said, “In the event that Ebola spreads to Alabama, we are ready and we are prepared to respond.”

Thursday, 9October2014, 6:18am

By Pippa Abston, MD, PhD

Alabama Governor, Dr. Robert Bentley, MD (a retired dermatologist) holds a Press Conference Wednesday, 08 October 2014 purporting to assert state readiness for the Ebola virus.

No, Dr. Bentley, we are in no way prepared.

First and most seriously, people lack insurance or have high co-pays/ deductibles, so they will delay going to the doctor or ER and expose others in the meantime.

Second, our public health infrastructure is underfunded and understaffed.

A couple of years ago I let the local HD (Health Department) know about a new viral syndrome I was seeing, which needed

Why did Parker Griffith vote AGAINST the Lilly Ledbetter Fair Pay Act?

Official portrait, Parker Griffith, MD as freshman member of the United States House of Representatives, Alabama 5th Congressional District.

Campaign photograph – 53rd Alabama Governor Robert Bentley, Jr., MD

As a politician, Parker Griffith has been described as “maverick.”

To describe it diplomatically, he has been “somewhat unpredictable.”

To be blunt, he’s a loose cannon.

His most recent political aspiration includes 2014 candidacy for Alabama governor under the Democratic ticket, challenging first term Republican Robert Bentley (described as “wildly popular”), whom is similarly a retired physician, and former Alabama State House Representative from Tuscaloosa, whom has publicly announced his opinion that he will be re-elected during a tour of Julia Tutwiler Prison for Women, where sexual assaults, and abuses of innumerable kind have become so rampantly commonplace that Alabama’s prison system is verging upon federal takeover.

It was during his tour of that prison that “Our kindly country doctor governor toured Tutwiler in early March and quietly said, “we are probably going to have to build some new prisons in my second term.””

Griffith’s greatest obstacle is his past. More specifically, the greatest mountain he must conquer is his decision to switch parties (from Democrat to Republican) while in his first term in Congress, which abruptly ended his political aspirations.

The nightmare of his actions still haunts Alabama voters, many whom have not forgotten – including those in his hometown, Huntsville & Madison County. Like the ghastly spectre in Charles Dickens’ classic fiction “A Christmas Carol,” Parker Griffith must come face-to-face with the Ghost of Election Past, and Bentley with the Ghost of Alabama Yet to Come.

And in this real-life play, Bob Cratchit is played by the people, while 18.1% of the state’s population (the state poverty rate) are cast as the sickly child, Tiny Tim. They and others are the ones whom are denied by the Scrooge, played by Governor Bentley and Republican-dominated state legislature.

In reality, Griffith and Bentley play dual roles in this real-life political /social /medical /economic drama.

Charles Dickens circa 1850: he ‘kept on going by taking on too much’. Photograph: Herbert Watkins

Is there salvation for Griffith?

Will Bentley expand Medicaid?

Can anyone really help the citizens of Alabama?

Tune in next time! when we hear _?_ say…

Griffith’s last foray into politics – as Representative for Alabama’s 5th Congressional District – did not bode well, for after the first full year of a two-year term, he announced he was changing political party affiliation, for which he was resoundingly criticized at home by his constituency, in the press for his actions, and then subsequently resoundingly defeated by GOP challenger “Mo” Brooks in the 2010 Republican primary.

When he represented Alabama’s 5th Congressional District in the United States House of Representatives, Parker Griffith voted against

Why Expand Medicaid in Alabama?

If Alabamians can’t work because they’re sick, and can’t get care because they’re poor, they can’t be productive citizens.

Should we just throw ’em to the wolves?

What will become of Alabama’s present, much less it’s future?

—

Alabama medical students argue for expansion of Medicaid

on May 07, 2014 at 9:39 AM, updated May 07, 2014 at 9:51 AM

By Swaroop Vitta and Davis Bradford

In medical school, our professors often show us maps of the U.S. illustrating where diseases strike hardest and where patient outcomes are the worst. Most of the time, Alabama is red, really red. Red is bad. So bad that over 600,000 Alabamians are uninsured and have limited to no access to health care.

Alabama is our home and this state’s spirit of compassion made us who we are. Every Sunday a small group of us with other medical students and volunteer physicians heads to a homeless shelter across from Regions Field that houses our free clinic. As we open our doors to many men and women that could not otherwise see a physician, we see first-hand what life without health insurance in Alabama is like.

A story:

Ms. C, a hardworking Alabamian, came into clinic with a terrible headache. It turned out that it was due to emergently high blood pressure. Ordinarily, this is easily treatable, but because Ms. C had gone without care for so long, she was now in danger of a stroke. Only the emergency room could provide relief.  But for Ms. C, like so many others in Alabama, that relief was accompanied by a bill she could never pay with the risk of unsurmountable debt. Ms. C has since become our regular patient. While her health has improved, there is only so much a group of well-intentioned medical students can do.

Had Ms. C received medical care during the years before we saw her, her high blood pressure could have been controlled before it left her with permanent injuries. Despite treatment, the chronic issues from those years without care now leave her unable to work. And at 58 years of age, her options are running low.

Even when work was an option, Ms. C’s income was

Alabama Medicaid Incompetency: State must repay Federal Childrens Health Insurance Program $88,197,498

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

How Honest is Your Doctor?

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?

Why?

What if your doctor prescribed the more expensive medication for you based on the fact that

Official Sources: Huntsville Hospital gets low patient safety rating, patients’ lives at risk

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

By Challen Stephens, The Huntsville Times

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

GOP Governors Deny Healthcare to their Poor Citizens

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

Huntsville Hospital Kills Child: Permanently Disabled 1y/o Later Died

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 | cstephens@al.com 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 / eschultz@al.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

Research: WalMart’s Low Wages Burden Taxpayers

The high cost of low living…

“Walmart’s employees receive $2.66 billion in government help every year, or about $420,000 per store.
They are also the top recipients of Medicaid in numerous states.
Why does this occur?
Walmart fails to provide a livable wage and decent healthcare benefits, costing U.S. taxpayers an annual average of $1.02 billion in healthcare costs.
This direct public subsidy is being given to offset the failures of an international corporate giant who shouldn’t be shifting part of its labor costs onto the American taxpayers.”

You’re the life of the party, everybody’s host
Still you need somewhere you can hide
All your good time friends
And your farewell to has-beens
Lord knows, just along for the ride

You think you’re a survivor
But boy, you better think twice
No one rides for nothin’
So, step up and pay the price

Dedicated to the GOP & other radical TEApublicans who worship the “almighty” dollar, tax cuts for the über wealthy, and their multinational corporate prophets.

---

Hidden Taxpayer Costs

Disclosures of Employers Whose Workers and Their Dependents are Using State Health Insurance Programs

Updated January 18, 2012

Since the mid-20th Century, most Americans have obtained health insurance through workplace-based coverage. In recent years there has been a decline in such coverage caused by a rise in the number of jobs that do not provide coverage at all and growth in the number of workers who decline coverage because it is too expensive.

Faced with the unavailability or unaffordability of health coverage on the job, growing numbers of lower-income workers are turning to taxpayer-funded healthcare programs such as Medicaid and the State Children’s Health Insurance Program (SCHIP).

This trend is putting an added burden on programs that are already under stress because of fiscal constraints caused by medical inflation and federal cutbacks. Many states are curtailing benefits and tightening eligibility requirements.

It also raises the issue of whether states are being put in a position of subsidizing the cost-cutting measures of private sector employers.

Across the country, policymakers and others concerned about the healthcare system are pressing for disclosure of information on those employers whose workers (and their dependents) end up in taxpayer-funded programs.

The following is a summary of the employer disclosure that has come to light so far. It includes two cases (Massachusetts and Missouri) in which the information was produced as a result of legislation. The other cases involved requests by legislators or reporters. The latter situations have sometimes resulted in data that are incomplete or imprecise, which suggests that only legislatively mandated, systematic disclosure will tell the whole story.

This compilation was originally produced by Good Jobs First as part of its preparation of testimony given before the Maryland legislature on an employer disclosure bill. A version of that testimony can be found here [1].

Alabama
In April 2005 the Mobile Register published an article citing data from the Alabama Medicaid Agency on companies in the state with employees whose children are participating in Medicaid. The newspaper obtained a list from the agency of 63 companies whose employees had 100 or more children in the program as of mid-March 2005. At the top of the list was Wal-Mart, whose employees had 4,700 children in the program. Following it were McDonald’s (1,931), Hardee’s (884) and Burger King (861). The data were similar to information obtained from the same agency by the Montgomery Advertiser two months earlier.

Sources: Sean Reilly, “Medicaid Providing Health Care for Kids of Working Families,” Mobile Register, April 17, 2005 and John Davis and Jannell McGrew, “Health Plans Not Family Friendly,” Montgomery Advertiser, February 22, 2005, p.B6.

Arizona
In July 2005 the state Department of Economic Security issued data on the largest private employers with workers receiving taxpayer-financed medical insurance through the Arizona Health Care Cost Containment System. At the top of the list was Wal-Mart, with about 2,700 workers–or 9.6 percent of its Arizona workforce–participating in the program. It was followed by

Alabama Governor Bentley Refuses to Help State’s Citizens

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.
—

Feds allow more time on health insurance exchange decision, but Alabama Gov. Robert Bentley says no thanks

By Kim Chandler | kchandler@al.com
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

Alabama Governor Robert Bentley Defies Federal Law, Refuses to Establish Healthcare Insurance Exchange for Citizens

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.

 

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Gov. Bentley says Alabama won’t set up exchange, expand Medicaid

By Kim Chandler | kchandler@al.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 | tmoore@al.com) / 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

Insurance companies increase profits after ObamaCare passed

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

The Theory of Everything

I’m elated to learn that there is a “Theory of Everything.”

As I delved further into it, I found that

Alabama’s Quandary: Nur$ing Homes, or Home Care?

It’s almost like trying to patch a roof while it’s leaking.

—

October 04, 2012

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

Reaching the End of Life: What Do We & Loved Ones REALLY Need?

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%.

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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:

Pharmaceutical Firms Lie, Cheat & Steal from America’s Elderly, Orphans, Poor and Helpless

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

Govenor Bentley begs, borrows or steals. -OR- What’s it like living in Alabama? Ever been continuously anally gang-raped?

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.

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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

Is Obamacare a Government Takeover of Medicine?

The truth speaks for itself.—

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?

States find private prisons too costly, move toward employment model

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.”

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From Prison to a Paycheck

Instead of training and counseling, Newark is trying work first—with promising results

By HOWARD HUSOCK

• LIFE & CULTURE
• August 3, 2012, 6:51 p.m. ET

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

Dirty Diapers and Death

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

I won the Alabama Lottery!

I won the Alabama Lottery, and all I got was this lousy governor and inept Republican legislature.

Alabama Governor, Robert Bentley, MD - (R)

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

SCOTUS, PPACA & American Healthcare: Links from Days 1 & 2

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

Day 2: SCOTUS hears PPACA argument

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

Alabama Governor Robert Bentley supports “ObamaCare”

UPDATED August 7, 2015 to include screenshot & URL.
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I can smell the hypocrisy cooking.

On one hand, the good governor and his legislature decries anything remotely resembling Democratic policies, but they sure don’t waste any time jumping on the bandwagon for those federal tax dollars to be doled out.

Goddamn hypocrites.

Read their crowing press release below.

December 30, 2011State of Alabama Press Release: MedicaidAlabama Medicaid receives $19 million performance bonus for efforts to enroll uninsured children in Medicaid

Governor Robert Bentley announced the Alabama Medicaid Agency will receive a $19 million federal performance bonus for the effectiveness of its innovative and user-friendly methods to enroll more low-income children in Medicaid during the 2011 Fiscal Year. Alabama is

Healthcare Reform Addresses Rising Health Care Costs

“Healthcare reform is going to happen because it has to. We cannot, as a country, continue to absorb cost increases in healthcare.”
– Cullman (AL) Regional Medical Center CEO, Jim Weidner, Thursday, 24 February, 2011 in his “State of the Hospital” address

The CEO’s address was encouraging, not the least reasons of which were that