What is socialism?

Socialism is when the government controls the means, and the method, of production.

In essence, socialism is a “government factory.”

But let’s examine some things that could be claimed are “socialist.”

Money.

The coinage and currency in your pocket is made by the United States government upon government-owned machines – stamping mills, and presses, with government-owned metals, government-owned paper, and government-owned inks.

But it’s not socialist.

Why not?

Because

Ed Henry, Former Alabama Republican State Representative, Pleads Guilty To Medicare Fraud Related To Massive Illegal Narcotics Prescription Operation

Corrupt Alabama Republican Politician Ed Henry Pleads Guilty

Ed Henry was a Republican Alabama State Representative from State House District 9, and misused, and abused the people’s trust, and office for personal, private gain.

Ed Henry has decided to PLEAD GUILTY to Federal charges of Healthcare Fraud involving a Montgomery pill mill – a clinic that dispenses controlled substances wrongfully and unlawfully, for non-medical reasons.

According to the indictment, “The practice was a lucrative business venture. In 2014, the practice earned gross receipts of or about $4,352,352.63. In 2015, the practice earned gross receipts of or about $3,292.549.40. In 2016, the practice earned gross receipts of or about $3,087,530.25.”

Earlier, all other involved parties in that case had plead guilty.

ALL PLEAD GUILTY TO FELONY CHARGES

They include:

1.) Dr. Gilberto Sanchez MD (License surrendered) – age 56, of Cecil, AL; 5 counts; plead guilty to drug distribution conspiracy, health care fraud, and money laundering charges

2.) Dr. Shepherd A Odom MD – (License surrendered) – age 78, of Alexander City; 2 counts; part owner of Family Practice, 4143 Atlanta Highway, Montgomery, AL until 2013 when he sold his interest to partner Dr. Gilberto Sanchez MD, though he continued to remain active, and launder money.

NOTE: Doctors Gilbert Sanchez and Shepherd Odom pleaded guilty prior to indictments in late 2017.

3.) Dr. Julio Delgado MD (ACTIVE License; License restricted) – age 56, of Homewood, AL; 22 counts; felony offense, aiding and abetting acquisition of a controlled substance by subterfuge, violation of Federal and State law

4.) Dr. Willie James Chester MD (License surrendered) – age 64, of Pike Road, AL
5.) Steven Edwin Cox NP (License revoked) – age 61, of Tallassee, AL; charged with 24 counts; pleaded guilty to two felony counts: conspiracy to distribute a controlled substance and health care fraud.

6.) Elizabeth Cronier NP (License revoked) – age 70, of Montgomery; charged with 15 counts
7.) Stephanie Michell Ott RN (License revoked) – age 42, of Fairhope, AL

8.) Misty Michelle Fannin – Administrator – age 41, of Tallassee, AL, money laundering

9.) Farley Pugh – Office Manager – age _?_, of _?_, pleaded guilty to conspiring to make false statements related to health care matters. NOTE: Earlier, in 2010, the AL Supreme Court ruled in a case involving Dr. Sanchez, and noted that Farley Pugh, who was Sanchez’ employee, had forged the signature of one of the parties in the case, Donna McKinney, in a bond-for-title agreement. 2010 Supreme Court of Alabama, Ex Parte Donna McKinney and Marlin McKinney Petition for Writ of Mandamus, in re: Gilberto Sanchez v Donna McKinney & Marlin McKinney (Elmore Circuit Court, CV-09-900268)

10.) Ed Henry – GUILTY

11.) Lillian Akwuba NP (License revoked) – age 38, of Montgomery; 28 counts TOTAL; 14 counts Health care fraud, aiding and abetting; 8 counts Controlled substance – sell, distribute, or dispense; aiding and abetting; Conspiracy to distribute controlled substance; Attempt and conspiracy to commit mail fraud; 2 counts Controlled substance: sell, distribute, or dispense; Money laundering – interstate commerce; Interstate Commerce; aiding and abetting;

12.) Jacqueline Suzanne Brownfield – Billing – age 33, of Wetumpka, healthcare fraud
13.) Akash Kumar – Billing – age 27, of Montgomery, healthcare fraud

Johnnié Sanders, LPC page

14.) Johnnié Chaisson Sanders – Licensed Professional Counselor – (Alabama Board of Examiners in Counseling LICENSE STATUS UNKNOWN) – age 48, of Wetumpka
Her page on the Healing Hearts Counseling website:
https://mentalwellnesscounselor.com/al/montgomery/johnnie-sanders/

License Number: 3130
Name: Johnnié Chaisson Sanders
Address: Healing Hearts Counseling Montgomery, AL 36117
Work Phone: (334) 425-5371
Expire Date: 7/31/2019

NOTE: In 2009, Ms. Sanders had earlier plead guilty to theft, fraud and aiding and abetting fraud charges in USA v Johnnie Chaisson Sanders, Case 2:08-cr-00204-WKW-TFM. USA v Johnnie Chaisson Sanders

Sanders provided bogus diagnoses of mental health conditions for the purpose of allowing Dr. Sanchez to support prescribing unnecessary medications. Sanders also collected cash payments from patients for counseling services even though she knew that Dr. Sanchez’s office would bill the patients’ insurance companies for the same services. On perjury, Sanders testified before a grand jury and falsely claimed that Dr. Sanchez did not require patients to undergo counseling sessions with her. In fact, as Sanders then knew, Dr. Sanchez required patients who received prescriptions for controlled substances to visit Sanders for mental health counseling.

Related News Releases by the Department of Justice, United States Attorney’s Office, Middle District of Alabama:

Tuesday, December 5, 2017
https://www.justice.gov/usao-mdal/pr/one-physician-and-three-nurse-practitioners-charged-participating-operation-montgomery

Monday, December 11, 2017
https://www.justice.gov/usao-mdal/pr/another-montgomery-pill-mill-doctor-pleads-guilty-drug-distribution-and-money

Wednesday, January 24, 2018
https://www.justice.gov/usao-mdal/pr/nurse-practitioner-pleads-guilty-drug-distribution-and-health-care-fraud-charges

Wednesday, January 24, 2018
https://www.justice.gov/usao-mdal/pr/three-clerical-workers-charged-participating-operation-montgomery-pill-mill

Thursday, March 1, 2018
https://www.justice.gov/usao-mdal/pr/another-doctor-and-nurse-indicted-participating-operation-montgomery-pill-mill

Tuesday, May 15, 2018 –
https://www.justice.gov/usao-mdal/pr/physician-nurse-practitioner-and-nurse-plead-guilty-montgomery-pill-mill-case

Wednesday, May 30, 2018
https://www.justice.gov/usao-mdal/pr/mental-health-counselor-indicted-health-care-fraud-and-perjury-offenses-stemming

Dr. Gilberto Sanchez MD, of Montgomery – Family Practice clinic owner – plead guilty in Federal court to healthcare fraud, money laundering, and drug distribution violations, sentenced to 12 years in Federal prison

Dr. Julio Delgado MD, 55 of Homewood

Nurse Practitioner Lillian Akwuba, 38 of Montgomery

Nurse Practitioner Steven Cox, 62 of Tallassee

Nurse Practitioner, Elizabeth Cronier, 69 of Montgomery

Dr. Willie Chester MD, 65 of Pike Road, plead guilty to one count of aiding and abetting the fraudulent acquisition of controlled substances, admitting that he wrote a prescription for clonazepam, commonly known as Klononpin, despite knowing the patient had no legitimate medical need for the medicine.

Delgado and the Nurse Practitioners conspired with Sanchez to unnecessarily and illegitimately prescribe controlled substances to the patients of Family Practice, and committed health care fraud by causing insurance companies to be billed for unnecessary office visits, which only purpose was to refill unnecessary medications, and that Akwuba conspired with Sanchez to launder money.

Ed Henry was charged with one count of conspiring to pay kickbacks and to defraud the U.S., one count of conspiring to commit health care fraud, one count of conspiracy to commit money laundering, five counts of health care fraud and six counts of paying unlawful kickbacks.

Ed Henry owned MyPractice24 which provided non-face-to-face chronic care management services to Medicare beneficiaries with two or more chronic conditions, and contracted with doctors to provided services who would bill Medicare for the services, then pay Henry’s company a share of the reimbursements from Medicare.

Ed Henry entered into an agreement with Dr. Gilberto Sanchez of Montgomery in 2016 in which MyPractice24 provided various kickbacks to Sanchez and his staff in return for referring Medicare beneficiaries to MyPractice24 for chronic care management services.

Ed Henry also assisted Sanchez in paying kickbacks to patients who enrolled in the chronic care management program which were paid by Sanchez by systematically waiving copays that Medicare required Sanchez to collect.

A corrupt Republican and former Alabama State Representative in House District 9 which includes parts of Morgan, Cullman, and Marshall counties, Ed Henry had a habit of saying very stupid things. He was also the state legislator who led the charge to impeach corrupt former Governor Robert Bentley who later resigned under a plea deal with state prosecutors.

Ironically, Henry was absent for most of the 2018 Legislative Session, and attempted to reassure his constituents that his absence was inconsequential by saying that,

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,

End ObamaCare’s Health Insurance Monopoly

Fact is, “ObamaCare” – which is properly known as the Patient Protection and Affordable Care Act, or ACA for short – though it’s monikered with POTUS Obama’s name, was largely a Republican brainchild from the über-conservative Heritage Institution.

The cornerstone of the act is predicated upon two items which are the very heart of the act: 1.) Guaranteed Coverage, and; 2.) Community Rating.

In was, in essence

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

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

Deep Data Mining & Personal Privacy: The NSA has NOTHING on BIG BUSINESS

Much ado about nothing.

That’s how I describe the recent ruckus & hullabaloo made about the recent UK news story that “revealed” the U.S. National Security Agency is “spying” on American citizens at home.

The reality is, that the information the NSA is creating is called “metadata,” is a set of data that describes & gives information about other data. Phone numbers called, dates, times & length of calls is NOTHING by comparison to what BIG BUSINESS knows about us already.

Why do you get certain junk mail?

Ever got junk mail from the AARP?

If you’re near age 50, or older, you probably already have.

Ever gotten junk mail from Social Security, Medicare, FDIC, or even your Congressman or Senator?

I dare say you have NEVER.

When you bought your car, if you borrowed money to purchase it, the bank or credit union which loaned the money to you performed a background credit check on you before they loaned their money to you.

Where do you think they got such information? The federal government?

Please… don’t insult my intelligence.

When you applied for a credit card, did you happen to list your age or birthdate on the application?

What about the life, health, auto, or house insurance policies you have? Did you mention your relationship status, number of children, their ages, specifics of your health including medicines, treatments, surgeries, income & source, length of residency, height, weight, or even the size, color & consistency of your last bowel movement?

I would imagine the answer to ALL those questions – at one time or another – has been “yes.”

And yet, unless you’ve served in the Armed Services, or as a

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

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%.

—

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:

Former Tennessee Senator & Cardiothoracic Surgeon Bill Frist, MD enters healthcare dialogue

Face it. Sooner or later, you’re going to die. Death is a part of life. Making a decision about whether or not you want to be connected to belts, tubes, hoses & pumps to circulate your blood, food & oxygen when your body would have naturally expired is essentially what the discussion is about.

—

The Bill Frist ℞

By: Brett Norman
September 16, 2012 11:06 PM EDT

Meet former Sen. Bill Frist, a renegade “Obamacare”-loving Republican who is in the mood for some real bipartisanship.

Yes, the same Frist who as Senate majority leader led an army into the culture wars over Terri Schiavo and whose efforts in 2004 to unseat his then-rival, Minority Leader Tom Daschle, led to a nasty — and personal — Washington battle royal.

Now, Frist is pushing for a national conversation on end-of-life care and dismissing “caricatured”talk of death panels. He’s committing Republican heresy in endorsing elements of the loathed Affordable Care Act. He’s standing shoulder to shoulder with Daschle in search of a bipartisan way to tackle one of the thorniest problems around: how to get control of health care costs before they sink the economy.

Frist is pushing for a national conversation on end-of-life care. | AP Photo

The Frist-Daschle reconciliation, in particular, is a source of amazement to some longtime Washington observers.

“I didn’t think they would ever talk again,” said Bill Hoagland, a budget expert and former aide to Frist who has joined the duo on a health cost control initiative at the Bipartisan Policy Center. “I was surprised, pleasantly, that they would work together.”

Daschle told POLITICO, “He’s been a very important partner and I would say has become a friend in spite of the fact that we’ve had a difficult history.”

“That is past and we now find much more in common than not,” he added. “We both know that we need to find a consensus way forward.”

Frist, a heart and lung transplant surgeon who is now focused on research and policy, is working on

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?

Led by GOP Speaker of the House John Boehner, Ladies and Gentlemen, introducing your “Do Nothing Congress” of 2012

Republican obstructionism, or Republican obstructionism?

So far this year, lawmakers have staged 195 roll-call votes, which boils down to only about 60 pieces of legislation, including post-office namings.

Among them are:
● The Mark Twain Commemorative Coin Act.
● The Sportsmen’s Heritage Act of 2012.
● Legislation requiring the Treasury to mint coins commemorating the 225th anniversary of the U.S. Marshals Service.
● The World War II Memorial Prayer Act.
● The Permanent Electronic Duck Stamp Act.

Because the Democrats lack a filibuster-proof majority in the Senate, they can bring virtually nothing to a vote without the blessing of the Republicans. Even with that hurdle, the Senate has been able to slog through a few bills in recent weeks, including

A Retrospective: Bush & the GOP’s Promises VS Reality

Does anyone remember this?

Nope. Probably not. That’s why it’s being posted here… to remind us all.

In the first Presidential Debate in 2000 with Vice President Al Gore, Jr. and former Texas governor & GOP candidate George W. Bush, the forum included questions on the topics of budget & economy, governmental reform, healthcare, Social Security, tax reform, education, energy & oil, foreign policy, homeland security, war & peace, and abortion.

As you read the responses below, consider how

Paul Ryan Will Save Social Security & Medicare

NOT!

The original title of this entry was “Paul Ryan Contradicts Himself & Pimps his Mother.”

For behold, it’s a case of “The pot calls the kettle ‘black.'”

First, he is a career politician damning “this board of bureaucrats,” of which he is a founding, card-carrying member.

Paul Ryan has never held an honest, private sector job a day in his life (if you count driving the Oscar Meyer Weinermobile during summer in college), and has ONLY had political jobs since he first started working.

He has completely IGNORED the findings of the Congressional Budget Office, the Office of Management and Budget and the Governmental Accountability Office, all who have independently found that the Patient Protection and Affordable Care Act decrease the budget and has NOT taken ANY money from Medicare, Medicaid or the Social Security Trust Fund (SSTF).

You know the saying:

Today Mitt Romney spoke out of the _?_ side of his mouth, and said:

“And you know what he did with it? He’s used it to pay for Obamacare, a risky, unproven, federal takeover of health care.” –Mitt Romney

Government estimates say that more than 6,000 jobs statewide and 20 percent of Iowa‘s electricity needs come from wind power, and the state’s senior GOP leaders all support renewing an extension of a wind tax credit that Romney opposes.

Romney’s campaign did not respond to repeated quests for his position on the other portions of the bill, which includes items such as a tax break for developers of NASCAR facilities and purchasers of electric motorcycles.

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http://www.businessweek.com/ap/2012-08-14/gop-ticket-faces-growing-pains-as-dems-attack
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FACT: The Congressional Budget Office (CBO) has determined that the Patient Protection and Affordable Care Act is fully paid for,

Q: Why do hospitals charge $75 for aspirin? A: Because they can.

It was once a long-standing joke that hospitals charged outrageous prices on medicines.

It’s not a joke anymore.

Once, a healthcare joke went like this:
Q: What’s the difference between a HMO, a PPO and the PLO?

A: You can negotiate with the PLO.

It’s not a joke anymore.

It should also be noted that a study conducted 26 years go by Jack D. McCue, Charles Hansen, and Peter Gal entitled “Hospital Charges for Antibiotics” found that:

“Hospital charges for intravenous antibiotics were obtained in a survey of 71 hospitals in 25 U.S. cities. Only 56.3% of the hospitals used their actual drug acquisition cost to calculate patient charges; the remainder used a base price derived from one of the wholesale price guides, which often seriously overstate the cost of antibiotics. Sixty-eight percent added a markup, averaging 134.5%, and 63.4% added a dispensing fee, averaging $5.47. A relatively high-dose, single-antibiotic regimen costs patients $50-$150 per day, independent of dose-preparation charges (average, $9.09 per dose) for a piggyback-type system or intravenous line-related charges. Antibiotics were least expensive in large hospitals and in those located in the northeastern United States. Charges for antibiotics are often inconsistently calculated, vary enormously among hospitals, and may be unfair to patients and confusing to physicians. Cost-conscious prescribing of antibiotics by physicians would be facilitated by a more consistent relationship between charges and true costs.”

That 1985 study may be found here.

The reader should also understand that in a hospital, ALL medications are administered by prescription only… even aspirin.

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Cost Spotlight: A 443% Markup on Prescription Drugs

Posted on April 30, 2012 by AHIP Coverage

Kaiser Health News/USA Today shines a spotlight on increasing hospital costs specifically the price markup of over-the-counter and prescription drugs hospitals administer to patients.  The story examines

What happens when physician pay is tied to efficiency & quality?

What would it be like if you were paid for your success?

What would it be like if you were rewarded for high efficiency?

Is it possible that successful patient outcomes could be correlated to compensation?

How would one measure non-compliant patients, or those with poor prognoses?

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Medicare moves to tie doctors’ pay to quality and cost of care

By Jordan Rau, jrau@kff.org Published: April 14

CMS plans to base the 2015 bonuses or penalties on what happens to a doctor's patients during 2013.

Twenty-thousand physicians in four Midwest states received a glimpse into their financial future last month. Landing in their e-mail inboxes were links to reports from Medicare showing the amount their patients cost on average as well as the quality of the care they provided. The reports also showed how Medicare spending on each doctor’s patients compared with their peers in Kansas, Iowa, Missouri and Nebraska.

The “resource use” reports, which Medicare plans to eventually provide to doctors nationwide, are one of the most visible phases of the government’s effort to figure out how to enact a complex, delicate and little-noticed provision of the 2010 health-care law: paying more to doctors who provide quality care at lower cost to Medicare, and reducing payments to physicians who run up Medicare’s costs without better results.

Making providers routinely pay attention to cost and quality is widely viewed as crucial if the country is going to rein in its health-care spending, which amounts to more than $2.5 trillion a year. It’s also key to keeping Medicare solvent. Efforts have begun to change the way Medicare pays hospitals, doctors and other providers who agree to work together in new alliances known as “accountable care organizations.” This fall, the federal health program for 47 million seniors and disabled people also is adjusting hospital payments based on quality of care, and it plans to take cost into account as early as next year.

But applying these same precepts to doctors is

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

Ending Obamacare

Among conservatives, there’s little argument that Obamacare should be abolished. ‘It’s time to get government out of our lives,’ they say.

They make many very valid points. Those same folks have expressed concerns that instead,

Conservatives prepare demands for budget talks

Certainly, there’s little or no disagreement that much change is needed in the way that national politics works. At its heart however, politics is the art of compromise. And politics, first begins in the home – because neither daddy, mama, nor children always get their way; but on occasion, daddy gets his way, mama gets hers, and by mutual consent with mama & daddy, on occasion the children get theirs. Changing the tenor of political operation in this nation begins with a few points, the first of which is that that we all love this nation, and seek the best for the people. One thing I’d like to see – which others have similarly expressed – is Term Limitations in the House and Senate; perhaps five in the House (10 years) and two in the Senate (12 years), for a grand total of 22 years service.

House conservatives prepare strong demands to raise the debt-ceiling

By Erik Wasson – 05/07/11 09:55 AM ET

House conservatives appear comfortable with being unable to get Medicare reform in exchange for the debt ceiling being raised and are coalescing around other strong demands including enactment of a balanced budget amendment.

Tea Party-backed freshmen and the Republican Study Committee are

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

“Do you have limited income and resources?”

So began the paragraph on a document sent to a retiree friend of mine.

The next paragraph read in part, “You may qualify for extra help paying your Medicare prescription costs.”

As I pondered the question it was suddenly obvious that everyone has “limited income and resources,” including Bill Gates and Warren Buffett.

…unless, of course, you’re God.