This morning on All Things Considered on NPR, there was a story called Becoming Close: The Geography of Friendship, by Allison Aubrey. As I listened I began to think about my own experiences with friends over the years, and specifically about friends in college. Many people I know developed great, enduring friendships in college.
One of the things in the story that stood out to me was the studies that had been conducted over the years that indicate that proximity has a lot to do with who we develop friendships with; particularly during the first year of college when everything is new and different. I thought this was ironic because what I wanted to do was to get away from people, not engage with them, share a room with someone, or be close to anyone.
My first semester of college was in Savannah, GA at the Savannah College of Art and Design. I was on the soccer team and we were there earlier than the rest of the students to start training. The dining hall was almost always empty except for us and sometimes the volleyball team or some other random people. I managed to sit completely separate for about a week before the rest my teammates dragged me over to sit with them. I figured that I had to give up my wish to be left alone to be a part of something bigger, the team.
In my dorm though I didn't have a choice either way as I was paired with a roommate. He hailed from the Northeast and was a total d-bag. While I was living with him, I certainly didn't want to be his friend, and I think he would've fucked his Grateful Dead bootleg tapes if he could have figured out how to do it. We were nothing alike and in this case, proximity was just downright unfortunate and mandatory. I made up for this by sleeping as much as I could through the day, other than class times, and then having the night as my awake time.
This solved the problem of having to put up with him, but it really wasn't a healthy schedule for a freshman 800 miles from home to try to keep. I had more than one mental breakdown and only stayed for that single semester. I did make some basic friendships with some of the guys on the team, but I could tell from that short time there that I would never really be able to forge a bond with anyone from then, regardless of how close I physically was to them, unlike the study I was listening to suggested.
I am happy for people that can create these friendships, and I probably would be a better person today had I been able to at some point make some lasting friends during my years in and out of college. The exact opposite has happened though...I have slowly disconnected from and lost all the friendships I built up from high school and into early adulthood.
Did this story on NPR make me feel melancholy? Maybe a bit, but I've been feeling that way pretty regularly these days anyway. It just made me laugh just a little that as proximity can build friendships, I realized that I was always trying to get single rooms, live by myself outside of school, or was avoiding being social whenever I could.
Monday, August 31, 2009
NPR Story on Friends in College
Sunday, August 16, 2009
Commentary on House Bill HR 3200 - America's Affordable Health Choices Act of 2009
A family member forwarded me an email from someone they know that took a supposedly close look at this bill and wanted to point out to all concerned parties how much evil euthanasia, rationing, and downright bad Orwellian stuff is in this bill and on the overall agenda of the Obama-ites. Well, I decided to take about 8 hours out of my weekend and review all the claims in the aforementioned email to check for accuracy. If the things this person claimed were true, really were, then I would be worried, too. But it turns out that it's just more of the same old inflammatory, bush-league scare tactics from a typical right-winger. The text below is formatted so that my responses are below each original claim. My words are in blue italics, his claims are in black text and not indented. This post is really long and I don't blame you if you don't read the whole thing, but I would recommend you do. There is so much mis-information out there right now, from Sarah Palin lying out of both sides of her mouth, to the typical wingnuts like Glenn Beck and others like him. It's good to be truly informed instead of led along like a dog on a leash, being fed lies like slop, day after day. I don't think any healthcare reform is going to be perfect, and I think it's going to take longer than a month to craft good legislation, but it makes me sick that there are a lot of people out there saying no to this thing out of hand to try to score a political victory. Oh, don't worry about it you clever republicans, just keep saying no to everything and you'll find yourself right back in power on the Hill...yeah, good to see you're doing what's best for America and just playing politics, lying your asses off, and being beligerent about it. You'll never get my vote. Not ever. My comments are based on review of the only actual bill that is officially viable as of 8-16-09, HR 3200. You can go here to read for it yourself - H.R.3200 - America's Affordable Health Choices Act of 2009. Also important in this review is the Social Security Act.
The original email begins here:
Pg 22 of the HC Bill MANDATES the Govt will audit books of ALL EMPLOYERS that self insure!!
I only found the word audit in other sections, like ones talking about SEC 142(b)(2)“The commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected non-compliance.”
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get (read euthanasia)
Why ‘read euthanasia’ here? There are govt committees that recommend standards for all kinds of things, like they already do for Medicare for example, so highlighting euthanasia is only inflammatory.
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!! You can only get so much "care" per year
This claim is totally false! There is no mention of rationing in this section, and the only limitation mentioned is that of an individual or a family’s total yearly out-of-pocket costs. This section doesn’t dictate how much “care” you can get per year, it just specifies the most anyone would have to pay for all the care they do receive.
Pg 42 of HC Bill - The Health Choices Commissioner will choose your HC Benefits 4 you. You have no choice!
This is what the pertinent section of the bill actually says “QUALIFIED PLAN STANDARDS- The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.” I read this to mean that the commissioner will establish standards (i.e. minimums) for plans, not take away your choices.
PG 50 Section 152 in HC bill - HC will be provided to ALL non US citizens, illegal or otherwise
FALSE!!! Here is the truth, directly from the language of the bill…” SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS - Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.”
Pg 58HC Bill - Govt will have real-time access to individs finances & a National ID Healthcard will be issued!
Also in this section, “(b) Limitations on Use of Data- Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual.”
Here is the actual wording of the referenced section…” (D) enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card”
Now, ‘financial responsibility’ in this section does not mean the govt is going to look at your credit or your bank account, that’s just not true. Healthcare providers do this already, they check to ensure that you’re eligible for coverage for the person you’re trying to see, or the service you’re trying to get, that’s all…no bogeymen in this one, sorry.
And the National ID Healthcard…there’s nothing whatsoever in here about a National ID, and that is also just an inflammatory use of another common public fear of Big Brother. Oh, and there’s another thing we already do when we go to receive healthcare; hand over our insurance cards.
Pg 59 HC Bill lines 21-24 Govt will have direct access to your bank accounts for elective funds transfer
This is a misleading statement, and is not spelled out in the bill. Since this section 4(C) comes right after the section that is mentioned above, 2(D), it more than likely means that it allows for immediate payment from your health insurance company for the amount they say they will cover, which has already been verified in the overall SEC 1173, of which this is a part. It really has nothing to do with the GOV taking your money at all it might have something to do with the HCP knowing instantly how much you are responsible for since the insurance has immediately paid their portion.
PG 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organisations (ACORN).
This claim is pure opinion and nothing like this is even remotely stated in the bill.
Pg 72 Lines 8-14 Govt is creating an HC Exchange to bring private HC plans under Govt control.
PG 84 Sec 203 HC bill - Govt mandates ALL benefit packages for private HC plans in the Exchange
Yes and no; the govt defines the minimums/base level coverage for plans to be eligible for inclusion the Exchange, not the totality of all plans and all options.
PG 85 Line 7 HC Bill - Specs for Benefit Levels for Plans = The Govt will ration your Healthcare!
False! The govt will not ration your healthcare, and this section in particular only talks about the creation of 3 tiers of plans, and that the commissioner will define the minimum/standard benefits for inclusion as a basic health care plan in the Exchange.
PG 91 Lines 4-7 HC Bill - Govt mandates linguistic appropriate services..... Example - Translation for illegal aliens
Another example – Braille for the blind. And I will reiterate that the bill specifically states that illegal aliens will not receive govt money for treatment!
Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps to sign up individually for Govt HC plan
In SEC 205, subsection c(3) this is what it says exactly, “(3) USE OF OTHER ENTITIES- In carrying out this subsection, the Commissioner may work with other appropriate entities to facilitate the dissemination of information under this subsection and to provide assistance as described in paragraph (2).” What difference does it make who the ‘other appropriate entities’ are anyway?
PG 85 Line 7 HC Bill - Specs of Benefit Levels for Plans. AARP members - your Health care WILL be rationed
False! The govt will not ration your healthcare, and this section in particular only talks about the creation of 3 tiers of plans, and that the commissioner will define the minimum/standard benefits for inclusion as a basic health care plan in the Exchange.
-PG 102 Lines 12-18 HC Bill - Medicaid Eligible Individuals. will be automatically.enrolled in Medicaid. No choice
False! Let’s see what the ACTUAL bill says (SEC 205, subsection d(3)) and please note the bolded text near the end…”AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO MEDICAID- The Commissioner shall provide for a process under which an individual who is described in section 202(d)(3) and has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.”
pg 124 lines 24-25 HC No company can sue GOVT on price fixing. No "judicial review" against Govt Monopoly
Can’t find this, so no comment yet.
pg 127 Lines 1-16 HC Bill - Doctors/AMA - The Govt will tell YOU what you can make.
I think this is the section you’re referring to, but please correct me if I’m wrong. Even though you cite page numbers it can be difficult to be sure we are looking at the same thing, but here is a critical element that precedes any language… (SEC 223 subsection 1) ”The Secretary shall establish payment rates for the public health insurance option for services and health care providers consistent with this section and may change such payment rates in accordance with section 224.”
The bill doesn’t tell doctors what they can and can’t charge, it says what the govt will pay under the public option, that’s it. They already do this for Medicare anyway. There’s a huge difference between ‘telling YOU what you can make’ and setting payment standards for just the public insurance option.
Pg 145 Line 15-17 An Employer MUST auto enroll employees into public opt plan. NO CHOICE
SEC 312 subsection c is what I assume you’re talking about, and if so, you’re again ignoring the options available…i.e. you’re lying about there being NO CHOICE. I don’t want to be belligerent, but not only are there choices, there is no MUST enroll into the public plan! If you really do see that language, please quote it directly so I can understand…you can’t just read the headlines of a section and then not read the actual legally-binding language within that section.
Let’s look at the language for this particular section: “(1) IN GENERAL- The requirement of this subsection with respect to an employer and an employee is that the employer automatically enroll suchs [sic] employee into the employment-based health benefits plan for individual coverage under the plan option with the lowest applicable employee premium.
(2) OPT-OUT- In no case may an employer automatically enroll an employee in a plan under paragraph (1) if such employee makes an affirmative election to opt out of such plan or to elect coverage under an employment-based health benefits plan offered by such employer. An employer shall provide an employee with a 30-day period to make such an affirmative election before the employer may automatically enroll the employee in such a plan.
Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.
Can’t find this, so no comment yet.
Pg 149 Lines 16-24 ANY Employer with payroll 400k & above who does not provide public option pays 8% tax on all payroll
I don’t see where it says any employer is taxed if they don’t provide the public option – I am looking in SEC 313 where the % tax table resides. In the rest of the bill they talk about any plan under the Exchange, not just the public option, so why is this section different? I could be wrong, but I think you’re being disingenuous by including the public option part of this comment.
pg 150 Lines 9-13 Biz w/ payroll between 251k & 400k who doesn't provide public option pays 2-6% tax on all payroll
I don’t see where it says any employer is taxed if they don’t provide the public option – I am looking in SEC 313 where the % tax table resides. In the rest of the bill they talk about any plan under the Exchange, not just the public option, so why is this section different? I could be wrong, but I think you’re being disingenuous by including the public option part of this comment.
Pg 167 Lines 18-23 ANY individual who doesn't have acceptable HC according to Govt will be taxed 2.5%
Correct – I think the idea is similar to being required to carry auto insurance…if you hit me and you didn’t have coverage, then all the costs are absorbed by me and my insurance company, which isn’t fair. If people either have a plan or are taxed, then there is money or a plan regardless of who gets ‘hit’ by an illness, etc.
Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from individual taxes. (You and I will pay for them)
According to US tax laws, a Non-resident Alien is “If a person does not meet either the Green Card or Substantial Presence Test, then that person is classified as a non-resident alien - A new arrival on a J-1 or F-1 visa is generally a non-resident alien” Also, Non-resident aliens are taxed only on their income from sources within the U.S. and on certain income connected with the conduct of a trade or business in the U.S. (source – Duke U. website)
Pg 195 HC Bill -officers & employees of HC Admin (GOVT) will have access to ALL Americans financial/personal records
Let’s look at the whole picture, and read the actual bill, not just cherry pick certain phrases to try to scare people! First, the info they have access to is your tax return info, and only certain parts of it at that – oh no! The govt already has this! This bill is not giving them access to information they don’t already know.
SEC 431 “(A) IN GENERAL- The Secretary, upon written request from the Health Choices Commissioner or the head of a State-based health insurance exchange approved for operation under section 208 of the America’s Affordable Health Choices Act of 2009, shall disclose to officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, return information of any taxpayer whose income is relevant in determining any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009.”
“(B) RESTRICTION ON USE OF DISCLOSED INFORMATION- Return information disclosed under subparagraph (A) may be used by officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, only for the purposes of, and to the extent necessary in, establishing and verifying the appropriate amount of any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009 and providing for the repayment of any such credit which was in excess of such appropriate amount.”
PG 203 Line 14-15 HC - "The tax imposed under this section shall not be treated as tax" Yes, it says that.
Yes, and it goes on to say…” The tax imposed under this section shall not be treated as tax imposed by this chapter for purposes of determining the amount of any credit under this chapter or for purposes of section 55.” I am guessing this is sarcasm here?
Pg 239 Line 14-24 HC Bill Govt will reduce physician services for Medicaid. Seniors, low income, poor will be very affected.
Can’t find this, so no comment yet.
Pg 241 Line 6-8 HC Bill - Doctors, doesn't matter what specialty you have, you'll all be paid the same
Can’t find this, so no comment yet.
PG 253 Line 10-18 Govt sets value of Dr's time, professional judgments, etc. Literally value of humans.
The literal value of a human??? I didn’t see that in there, in fact, what I saw was a section about the Secretary using things like “work elements (such as time, mental effort and professional judgment, technical skill and physical effort, and stress due to risk) involved with furnishing a service” to evaluate the potential addition of, and fees associated, in the IDENTIFICATION OF POTENTIALLY MISVALUED CODEs. This is what the whole section is about (SEC 1122)
I am not sure how one can extrapolate the value of a human being set into law from a section talking about identifying and updating billing codes?!
PG 265 Sec 1131Govt mandates & controls productivity for private HC industries
This section of the bill amends the Social Security Act, which is current law, to include dates for implementation of productivity adjustments to the sections of the Act pertaining to ‘PAYMENT TO HOSPITALS FOR INPATIENT HOSPITAL SERVICES’ It doesn’t sound as sinister as this comment makes it out to be.
PG 268 Sec 1141 Fed Govt regulates rental & purchase of power driven wheelchairs
False! – c’mon, this small part only amends the Social Security Act by “(2) by striking ‘power-driven wheelchair’ and inserting ‘complex rehabilitative power-driven wheelchair recognized by the Secretary as classified within group 3 or higher’.”
PG 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
This sounds scary, but guess what, it’s not rationing! I repeat; this rationing claim is false! SEC 1145 – “(A) STUDY- The Secretary shall conduct a study to determine if, under the system under this subsection, costs incurred by hospitals described in section 1886(d)(1)(B)(v) with respect to ambulatory payment classification groups exceed those costs incurred by other hospitals furnishing services under this subsection (as determined appropriate by the Secretary).”
“(B) AUTHORIZATION OF ADJUSTMENT- Insofar as the Secretary determines under subparagraph (A) that costs incurred by hospitals described in section 1886(d)(1)(B)(v) exceed those costs incurred by other hospitals furnishing services under this subsection, the Secretary shall provide for an appropriate adjustment under paragraph (2)(E) to reflect those higher costs effective for services furnished on or after January 1, 2011.”
This is not rationing, this is researching to find out why some hospitals charge more for the exact same services, and then granting the power to make adjustments to the fee scale that govt is willing to pay hospitals for those services. This is the stuff we should want to see more of in my opinion…let’s see where we can cut costs by finding out how much it actually does cost to perform a service, and holding providers to that reasonable standard.
Finally, to be clear, this section only updates Social Security law, meaning that it applies to Medicare and that’s it, unless I am mis-reading something?
Page 280 Sec 1151 The Govt will penalize hospitals for what Govt deems preventable re-admissions.
This section updates the Social Security Act, and just like these last few sections, only applies to Medicare. In general the intent behind the amendment is good I think because readmissions are more costly than keeping someone in the hospital in the first place and/or doing the job right the first time. Not that there aren’t other issues here and difficulties for hospitals, because they can’t control what someone does when they leave the hospital, for example.
Pg 317 L 13-20 OMG!! PROHIBITION on ownership/investment. Govt tells Doctors. what/how much they can own.
Hold on, in the context of this section of the bill (SEC 1156 (i) Requirements To Qualify for Rural Provider and Hospital Ownership Exceptions to Self-referral Prohibition-) the bill says that if you want to refer patients to a hospital that you are a part-owner or investor in, you cannot own more than ‘x’ % or expand beyond current levels. The bill also provides a provision for requesting an exception to this rule as well.
Also, this provides only for an amendment to the Social Security Act – SEC 1877, meaning this only applies to Medicare. As a physician you are not legally allowed to refer a patient to an entity providing healthcare if they have a financial relationship with that entity beforehand. There are many exceptions in the Act regarding physician services, group practices, etc.
Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion- Govt is mandating hospitals cannot expand
See comment directly above…
pg 321 2-13 Hospitals have option to apply for exception BUT community input required. Can you say ACORN?!!
Why is everyone so afraid of ACORN and why are they being dragged into the healthcare debate? Oh my, they’re so scary and stuff! C’mon, discussing the issues is great, but it’s better when people leave out the bogeymen that have nothing to do with the issues. Oh, and by the way, communities have input on all kinds of expansions…Wal-Mart can’t just waltz into town without some community input in most places.
Pg335 L 16-25 Pg 336-339 - Govt mandates establishment. of outcome based measures. HC the way they want. Rationing
Here’s what the bill actually says, and please be sure to read past the headline in all caps, because that’s where the ACTUAL important language is…
“SEC 1162 3(B)(ii) ESTABLISHMENT OF OUTCOME-BASED MEASURES- By not later than for 2013 the Secretary shall implement reporting requirements for quality under this section on measures selected under clause (iii) that reflect the outcomes of care experienced by individuals enrolled in Medicare Advantage plans (in addition to measures described in clause (i)”
So to determine Medicare payments in 2013 and beyond, the govt will rank the quality of measures using reporting from outcomes of those measures on actual patients. How is this even remotely anywhere near rationing? Please explain it to me if you can, because I really do want to understand how this is the same thing. Also, just to note, this affects only Medicare Advantage plans.
Pg 341 Lines 3-9 Govt has authority to disqualify Medicare Adv Plans, HMOs, etc. Forcing all into Govt HC plan
Again, read beyond the headline!!!!!!!
“SEC 1162 3(E)(iv) AUTHORITY TO DISQUALIFY CERTAIN PLANS- In applying clauses (ii) and (iii), the Secretary may determine not to identify a Medicare Advantage plan if the Secretary has identified deficiencies in the plan’s compliance with rules for such plans under this part.”
This is simply to apply a status to a plan on whether or not it qualifies for a ‘quality performance payment adjustment.’ I am not sure how this is supposed to end up “forcing all into govt HC plan.”
Pg 354 Sec 1177 - Govt will RESTRICT enrollment of Special needs
False! This section modifies the SSA SEC 1859(f)(1), by “by striking ‘January 1, 2011’ and inserting ‘January 1, 2013 or January 1, 2016” which already restricts Medicare Adv plans to certain classes of special needs individuals (defined in SSA SEC 1859(b)(6)).
Pg 379 Sec 1191 Govt creates more bureaucracy - Telehealth Advisory Cmtte. Can you say HC by phone?
This section resides under Subtitle F - Medicare Rural Access Protections, and therefore makes more sense in this context. I certainly don’t want healthcare by phone, but it is understandable that it could be a valuable service in a rural environment (think poison control center hotline.)
PG 425 Lines 4-12 Govt mandates Advance Care Planning Consult. Think Senior Citizens end of life. Seniors will be interviewed every year for health issues and decisions made as to what care you can or can't receive
False! - This claim is just pure bull*#&@, and I am going to try really hard to be civil here. I am sick of the outright lies about this section of the bill because it’s so easy to scare people with this topic. This is the infamous SEC 1233.
Seniors won’t be ‘interviewed’ about their health issues. And the section does not say anything about what care you can or can't receive! This is just an outright lie and it’s not in the bill anywhere. Here’s what is in the bill…”(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.”
The section says your doctor will get paid to talk to you about “advance care planning, including key questions and considerations, important steps, and suggested people to talk to.” You have every right to lay out in advance what care you ‘want or don’t want’ and this provision in the bill allows Medicare to pay for this conversation with your doctor every 5 years or if there’s a major change to your health status.
Pg 425 Lines 17-19 Govt will instruct & consult regarding living wills, durable powers of atty. Mandatory!
False – it’s absolutely not mandatory! You have the option to speak with your doctor about “advance directives, including living wills and durable powers of attorney, and their uses.” The wording is “An explanation…”
PG 425 Lines 22-25, 426 Lines 1-3 Govt provides approved list of end of life resources, guiding you in death
This is what the bill says, and it’s not as sinister as this claim makes it sounds…” (D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965.)”
PG 427 Lines 15-24 Govt mandates program for orders for end of life. The Govt has a say in how your life ends
FALSE! They will not have a say in how your life ends.
This section says that the bill “(I) ensures such orders are standardized and uniquely identifiable throughout the State; (II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment; (III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and (IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
I for one am glad that this bill is trying to make clear, concise, and easily available, any wishes I might have for the end of my life. There are federal standards for all kinds of thing, and this will just add what is basically a paperwork standard to anybody on Medicare.
Pg 429 Lines 1-9 An "adv. care planning consult" will be used frequently as patients health deteriorates
False – Here’s the bill itself, note the bolded words…” (B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.”
May, in legal terms, means can, not must. If your health status changes significantly you very well may want to have another talk with your doctor about advanced care planning, even if you had one within the last 5 years.
PG 429 Lines 10-12 "adv. care consultation" may include an ORDER for end of life plans. AN ORDER from GOV
False – it’s not an order from the govt, this is your doctor or nurse practitioner you’re talking to, not some bureaucrat! And of course you may come to a conclusion about end of life plans after talking with your doctor, why is that so unusual or ominous? Let’s not be spreading rumors that the govt will be creating orders for you or about you…that’s just cheap scare tactics as usual.
Pg 429 Lines 13-25 - The govt will specify which Doctors can write an end of life order.
Let’s let the bill do the talking again…” (i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant)…”
PG 430 Lines 11-15 The Govt will decide what level of treatment you will have at end of life
FALSE! Read the bill and you’ll see that this is untrue, these lines in the bill talk about the type of treatment you have specified for yourself! “(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items—“
Section A(ii) referenced in this quote is “…communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;”, meaning that your preferences determine what level of treatment you will have at end of life, not the bloody govt.
Pg 469 - Community Based Home Medical Services=Non profit organizations. Hello, ACORN Medical Services here!!?
Again with ACORN. I don’t get it. This section also applies to churches and other relief organizations as well. Does ACORN work directly with physicians to supply medical home services to high-needs beneficiaries?
Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment to a community-based org. Like ACORN?
Just stop it with ACORN already. And separately, if you provided a service, would you not want payment for that service? This part of the bill just says that if you’re a community-based organization providing medical home services to patients, you’ll get paid once a month.
PG 489 Sec 1308 The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage
This section amends the SSA SEC 1861. Govt being inserted into your marriage??? Where does this happen? The bill simply indicates Medicare will cover these types of services from a therapist when otherwise it would have to have been a physician to be reimbursed by Medicare.
Pg 494-498 Govt will cover Mental Health Svcs including defining, creating, rationing those services
There is no rationing! This section also amends the SSA SEC 1861 and also just states that mental health counseling is covered when it is performed by licensed professionals other than your normal doctor. Please show me the part of the bill where the govt will be creating and rationing mental health services, because I can’t find it.
Pg 494-498 Govt will cover Mental Health Svcs including defining, creating, rationing those services
There is no rationing! This section also amends the SSA SEC 1861 and also just states that mental health counseling is covered when it is performed by licensed professionals other than your normal doctor. Please show me the part of the bill where the govt will be creating and rationing mental health services, because I can’t find it.
Monday, July 06, 2009
Bell's Amber Ale - TASTY!
Here's a cool profile of Bell's brewery and all the different beers that they make.
Saturday, February 14, 2009
It's Only a Pyramid
Foul and dry. Dust and dread. It's only a pyramid.
It's only life as god or subject.
Wind and poison. For the truth...for the king.
I am no king, I have no truth,
and I am not a builder.
I am not a man living in a time.
What I am is not.
Let the rain come, let the slag run off the roofs,
into the streets - onto the everydays, the usuals.
For each dream whisping up into the hot night,
another midnight thought, awake, descends.
Wednesday, February 04, 2009
Wednesday, January 28, 2009
I Met Someone
Yep, it's true. This old hermit has stumbled upon an amazing, talented, and beautiful woman who actually likes him! I know! Seriously, I am not lying. I keep having to convince myself this is really happening...kinda like a vivid dream where when you wake up you cower in bed under the covers, mortified, thinking that the horrible things you did in that dream in fact did happen.
Tuesday, January 27, 2009
14 Hands Cabernet - WOW
I was at Dolce Vita in Little Italy in Cleveland, OH the other day. First of all, the atmosphere and the service there were first rate. I'd go back there in a heartbeat. I had the 4-cheese ravioli in a special alfredo sauce...mmmm.
