NEO-LIBERALS ARE NOT DEMOCRATS FOLKS----THEY WORK FOR WEALTH AND PROFIT----STOP ALLOWING A DEMOCRATIC NATIONAL PARTY CONTROLLED BY NEO-LIBERALS CHOOSE YOUR CANDIDATES IN PRIMARIES!

CINDY WALSH FOR GOVERNOR OF MARYLAND IS THE ONLY CANDIDATE FIGHTING GLOBAL CORPORATE CONTROL OF OUR ECONOMY!

DO YOU KNOW WHY THE MEDIA HAS MADE A CIRCUS OF THE RIDICULOUS HEALTH CARE SYSTEM ROLL-OUT?  IT TAKES ALL OF THE MEDIA ATTENTION FROM WHAT IS REALLY HAPPENING WITH THE AFFORDABLE CARE REFORM.

I'll move on to Social Security on Friday but wanted to look specifically at what will happen with the Affordable Care Act in place as affects PHARMA.  Remember, Trans Pacific Trade Pact acts to curb all subsidy to PHARMA in nations joined to this treaty and to curb manufacturing of generics----a big business in developing nations.  Bill Gates and his PHARMA empire want to maximize profits by getting rid of generics and extending patenting rights to name brand.  That is what TPP does.  We already know what happens when an industry develops global markets-----the prices climb to 'market-value' and start being inflated by market speculation and manipulation.  So, we know PHARMA prices will soar with ACA.  Look below to see some of the effects already as drugs become scarce because they do not bring profits and generic prices rise as nations around the world are forced to close generic PHARMA factories. 

THE UNITED STATES IS DOING THIS AND IT IS OBAMA AND THE NEO-LIBERALS IN CONGRESS ALLOWING HEALTH CORPORATIONS TO WRITE THESE POLICIES.

Keep in mind as well-----when all this instability in pricing that comes with global market pricing and speculation, small businesses will not be able to stay in business.  There goes more small businesses in our communities....our local pharmacies.  Each time neo-liberals introduce these consolidation and deregulation policies as Clinton did and now Obama----an entire industry becomes controlled by the few global corporations at the top and prices soar, quality disappears, and service declines.

THIS IS WHAT WILL HAPPEN IF THE AFFORDABLE CARE ACT IS ALLOWED TO CONTINUE.  NEO-LIBERALS WORK FOR WEALTH AND PROFIT----THEY ARE NOT DEMOCRATS.

Expanded and Improved Medicare for All takes all of the global health systems out of the mix eliminating private insurers......controlling profit-margins through public market-share.  Cindy Walsh for Governor of Maryland will build several small generic manufacturing facilities across Maryland to supply the citizens with all the generics they need and we can contain the costs.


Pharmacists concerned about drug pricing, Affordable Care Act

Posted: Sep 30, 2013 4:39 PM EST Updated: Sep 30, 2013 4:47 PM EST By Rebecca Trylch l   SWARTZ CREEK (WJRT) - (09/30/13) - The lead-up to the beginning phases of the Affordable Care Act has been a roller coaster ride for some independent pharmacies.

In recent months some pharmacists say generic drug prices have uncharacteristically spiked.

A couple of the pharmacists ABC12 spoke with directly tie that roller coaster effect to the Affordable Care Act, also referred to as Obamacare. Others aren't ready to link the two together.

But here's what pharmacist Mark Luea with Luea Pharmacy in Swartz Creek tells us has happened to him.

Since June he's seen several of his generic prescription drug prices go up, drastically.

One example he provided involved an anti-seizure medication.

It was just under $135 one week. The very next week that same drug cost more than $1,600.

"When I see the drastic prices, our jaws drop," Luea said. "This is not normal. This is the first time I've seen anything like this in the pharmaceutical market in 30 years."

When Luea questioned the increase, he was first told there was an issue with the raw materials.

Then he was told a contamination issue shut down the place it was made in India, causing a supply shortage.

Later he was told by his wholesale supplier, who he buys most of his prescription drugs from, that manufacturers were to blame.

"Apparently the manufacturers are concerned that their profits are going to be cut horribly by the Affordable Care Act. So it's kind of the feast and famine, and right now they're really feasting," Luea said. "They're worried about a fixed profit that is going to be starting Jan. 1, 2014."

Luea says the ever-changing prices has lead to a related battle with health insurance companies that is costing him money.

Sometimes insurance companies won't reimburse him for the full cost that he paid.

"So who gets hurt? The pharmacy, not just my retail pharmacy, all retail pharmacies, and of course ultimately the consumer," Luea said.

He hopes this struggle isn't permanent.

"I truly, truly believe that the wholesale manufacturers of generic drugs will continue this high pricing right up until Dec. 31. After that, we'll see."

The Michigan Pharmacists Association is concerned about drug pricing and insurance reimbursement problems too.

And while it's not linking the issue to the Affordable Care Act, it is urging its members to contact their state lawmakers.

Chief Executive Officer Larry D. Wagenknecht also released this statement:

"When the pharmacist's cost to purchase generic prescription drugs increases, insurance companies and pharmacy benefit managers are very slow at raising their reimbursement rates, sometimes taking week to months. Because of this, pharmacists are unable to provide the essential medications and treatments required to care for their patients."


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As you see below, the ACA hands ever more ability of states to decide all avenues of health care and policy so each state will look differently as to how it will meet the continual gutting of funding of Medicare and Medicaid-----if you are going to dismantle a Federal program you first piecemeal the power of policy and that is what the ACA does.

Looking at drug costs we already see where citizens are having to make decisions as to what health insurance plan to buy according to what PHARMA or medical procedures it covers.  Everyone knows a person cannot be adequately covered under this process and that such piece-mealing with make costs soar for the American people trying to get what they need.  This is happening first with the lower-level plans like Medicaid and Bronze plans but it will engulf Medicare as it ends as a Federal program and the costs to upper-tier plans like Silver and Gold plans will take more and more disposable income from the upper-middle.

THE BOTTOM LINE IS THAT THE CREATION OF GLOBAL HEALTH SYSTEMS DRIVEN BY WORLD MARKETS WILL COMPLETELY DISMANTLE OUR FEDERAL PROTECTIONS AND BENEFITS WE RECEIVE THROUGH  OUR FEDERALLY RUN HEALTH PROGRAMS.

Remember, this is exactly what happened to the financial industry when Clinton deregulated and consolidated to create the global banking system.  We are now paying for financial services with fees for every single service----and that will be what health care will look like under ACA.  You will be forced to purchase your health plan like you do cable television stations.

Raise your hands if you knew that handing the responsibility of controlling health costs to the very health institutions creating the soaring costs would result in the American people unable to access most health care and in this case PHARMA!  EVERYONE.  So, when the Affordable Care Act states its intentions were to lower cost and all we see is what happens when corporations are encouraged to consolidate and grow in power----maximization of profit by any means------

WE KNOW THAT NEO-LIBERALS ARE LYING ABOUT THE INTENT OF THE AFFORDABLE CARE ACT.



'Although the money for covering uninsured Americans is coming from Washington, the heath care law gives states broad leeway to tailor benefits, and the local approach can also allow disparities to emerge'.

Drug Cost May Vary Greatly By State After Obamacare Implementation

By RICARDO ALONSO-ZALDIVAR 05/13/13 11:35 AM ET EDT

  WASHINGTON — Cancer patients could face high costs for medications under President Barack Obama's health care law, industry analysts and advocates warn.

Where you live could make a huge difference in what you'll pay.

To try to keep premiums low, some states are allowing insurers to charge patients a hefty share of the cost for expensive medications used to treat cancer, multiple sclerosis, rheumatoid arthritis and other life-altering chronic diseases.

Such "specialty drugs" can cost thousands of dollars a month, and in California, patients would pay up to 30 percent of the cost. For one widely used cancer drug, Gleevec, the patient could pay more than $2,000 for a month's supply, says the Leukemia & Lymphoma Society.

New York is taking a different approach, setting flat dollar copayments for medications. The highest is $70, and it would apply to specialty drugs as well.

Critics fear most states will follow California's lead, and that could defeat the purpose of Obama's overhaul, because some of the sickest patients may be unable to afford their prescriptions.

"It's important that the benefit design not discriminate against people with chronic illness, and high copays do that," said Dan Mendelson, president of Avalere Health, a data analysis firm catering to the health care industry and government.

Avalere's research shows that 1 in 4 cancer patients walks away from the pharmacy counter empty-handed when facing a copay of $500 or more for a newly prescribed drug.

"You have to worry about a world where if you happen to contract cancer or multiple sclerosis, you are stuck with a really big bill," Mendelson said. "It's going to be very important for states to take a long, hard look at their benefit design."

Although the money for covering uninsured Americans is coming from Washington, the heath care law gives states broad leeway to tailor benefits, and the local approach can also allow disparities to emerge.

A spokesman for Covered California said state officials are trying to balance between two conflicting priorities: comprehensive coverage and affordable premiums.

"We are trying to keep the insurance affordable across the board," said Dana Howard, the group's spokesman. "This is just part of trying to manage the overall risk of the pool." Covered California is one of the new state marketplaces where people who don't get coverage on the job will be able to shop for private insurance starting this fall. Coverage takes effect Jan. 1.

Insurers are forecasting double-digit premium increases for individual policies, as people with health problems flock to buy coverage previously denied them. The Obama administration says the industry warnings are overblown, and that for many consumers, premium increases will be offset by tax credits to help buy insurance. And officials say it's important to realize that the law sets overall limits on patients' liability, even if those seem high to some people. Still, a full picture of costs and benefits isn't likely to come into focus until the fall.

Howard said California officials are aware of the concerns about drug costs and are trying to make medications more affordable.

Meanwhile, he said consumers will be protected because the law limits total out-of-pocket costs – the deductibles and copayments that policy holders are responsible for, apart from monthly premiums. In California, the annual out-of-pocket limit for an individual is $6,400, although it can be as low as $2,250 for low-income people. Once that limit is reached, insurance pays 100 percent.

That's still a lot of money, and such reassurances haven't dispelled the concerns.

"The intent of the Affordable Care Act is to make sure that all Americans have access to quality, affordable health care," said Brian Rosen, a senior vice president of the Leukemia & Lymphoma Society. He adds that there is a danger that the insurance marketplaces "will discriminate against the patients with the highest medical need. That would completely undermine the spirit of the ACA."

The group has been joined by Rep. Doris Matsui, D-Calif., in urging state officials to reconsider the policy. The high copays "could prevent many patients from receiving the lifesaving treatments they need because of prohibitively high cost," Matsui wrote to the state.

The problem with costly drugs is similar to another money issue with the health care law – a provision that could price millions of smokers out of coverage. Insurers are allowed to charge tobacco users buying an individual policy up to 50 percent higher premiums. For a 55-year-old smoker, the penalty could reach nearly $4,250 a year, on top of the standard premium. California is trying to override that problem by passing its own law. There's also pending state legislation to address some issues with prescription costs, but its prospects are unclear.

Meanwhile, leukemia patient Lisa Lusk worries about what will happen to her. A nursing assistant who lives near Fresno, Lusk is hoping to return to work in the next few months. When that happens, she expects to lose emergency coverage she's now getting through the state. And the medication Lusk takes to manage her chronic form of the disease costs more than $5,000 a month.

"I'm scared that when I get a job my copay may be more than $1,500 a month," said Lusk. "I'll just be working to pay for my medications."
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So, the health market manipulation begins as Obama's Health Secretary says------she does not see the state health plans under ACA as FEDERAL HEALTH CARE PROGRAMS HELD TO FEDERAL PROTECTIVE LAWS.  So, bring the fraud and corruption on says the neo-liberal Sebelius-------lying, cheating, and stealing rules with the Affordable Care Act.

'HHS Secretary Kathleen Sebelius on October 30 sent a letter that threatens to further exacerbate health insurance affordability concerns.  The Sebelius letter to Rep Jim McDermott (D-WA) says that HHS “does not consider” qualified health plans under the Affordable Care Act to be “Federal health care programs” for purposes of federal anti-kickback rules.  Pharmaceutical industry representatives cheered this letter because, in their view, it gives a green light to the use of copay coupons'.

Remember, Obama appointed Sebelius knowing this Kansas insurance regulator had a history of working for the health insurance industry, not the public.  So, having Sebelius set the legal stage for making it harder for the public to seek justice from abuse of the Affordable Care Act would be expected.  Below you see the conversation over 'co-pay coupons' designed to undermine any effort to make these state insurance systems 'affordable'.  What will people who cannot meet co-pays and deductibles do to access the most limited amount of care?  Go to coupons.

Keep in mind as well, the ACA is premised completely on high levels of subsidy and in this age of massive corporate fraud and exploding economies drawing government coffers deeper into debt------

THOSE SUBSIDIES WILL DISAPPEAR JUST AS PUBLIC SECTOR EMPLOYEE BENEFITS ARE DISAPPEARING.

Can you imagine as a family trying to figure out how to buy insurance with a hodge-podge of coverage designed to have costs soar if you need to go outside of what is listed in a plan? 

WAKE UP PEOPLE-----YOU ARE BEING TAKEN TO THE CLEANERS AND THIS IS LIFE AND DEATH!

Simply ending this very private and profit-driven state health system and replacing it with Expanded and Improved Medicare for All will keep our Federal Medicare program strong and keep health care coverage standard for all. 

MARYLAND HAS ONE OF THE WORST OF PRIVATE HEALTH PLANS AND HAS ALREADY MOVED AWAY FROM ANY FEDERAL OVERSIGHT.  IT ALSO HAS THE GREATEST HEALTH DISPARITIES.

Insurance Premiums Affordable Care Act — HHS Blind Eye to Copay Coupons Will Lead to Increased Health Insurance Premiums

11-7-2013 | 1 Comment | Edward C Lawrence



As if the White House and the Department of Health and Human Services (HHS) weren’t already feeling political heat over the botched federal health insurance website launch and over health insurance cancellation letters and increased premiums for millions of Americans, HHS Secretary Kathleen Sebelius on October 30 sent a letter that threatens to further exacerbate health insurance affordability concerns.  The Sebelius letter to Rep Jim McDermott (D-WA) says that HHS “does not consider” qualified health plans under the Affordable Care Act to be “Federal health care programs” for purposes of federal anti-kickback rules.  Pharmaceutical industry representatives cheered this letter because, in their view, it gives a green light to the use of copay coupons.

We have written about how drug manufacturer copay coupons for brand-name drugs increase health insurance costs by undercutting health plan incentives for beneficiaries to use equally appropriate generic or less-expensive brand drugs.  In an interview we published in September, Kevin G. McAnaney, a former official in the HHS Inspector General’s office, talked about how the use of copay coupons in connection with federally-subsidized health insurance plans under the Affordable Care Act would likely violate federal anti-kickback laws.  In McAnaney’s view, federally subsidized plans under the Affordable Care Act, whether purchased on the federal exchange or in state exchanges, are “Federal health care programs” subject to criminal anti-kickback laws.  McAnaney talked about the potential legal exposure of pharmaceutical companies offering copay coupons and pharmacies accepting them.

Secretary Sebelius’s letter stating that HHS does not consider ACA health insurance plans to be “Federal health care programs” provides absolutely no legal justification for its conclusion.  The letter correctly recites that under the relevant portion of the anti-kickback law, a “Federal health care program” is “any plan or program that provides health benefits, whether directly, through insurance, or otherwise, which is funded directly, in whole or in part, by the United States Government…or any State health care program….” But then the letter simply states that the department “does not consider” qualified health plans and other programs related to the Federal health exchange to be “Federal health care programs.”  The letter goes on to say this includes the State-based and Federally-facilitated Marketplaces; the cost-sharing reductions and advance payments of the premium tax credit; navigators and other federally-funded consumer assistance programs; and co-op health plans.  According to the letter, this “conclusion was based upon a careful review of the definition of ‘Federal health care program’ and an assessment of the various aspects of each program under Title I of the Affordable Care Act and consultation with the Department of Justice.”  That’s the entirety of the HHS rationale!

Fortunately for those whose health insurance premiums would be increased if copay coupons are allowed under Affordable Care Act plans, the HHS letter is not the final word.  The Sebelius letter does not, and cannot, change the underlying Federal anti-kickback rules that will almost certainly be interpreted by the courts.  According to a Wall St. Journal article, “Branded Drugs Chalk Up a Win Under Health Law” (Nov. 3, 2013), the “Pharmaceutical Care Management Association plans to challenge the HHS determination.”  The HHS decision “also could be reversed …by one of the lawsuits that union health-insurance plans and other plaintiffs have filed to block copay-card use, or by a probe by the HHS Office of Inspector General into illegal copay-card use by Medicare Part D beneficiaries.” 

Perhaps more of a risk for drug companies and pharmacies involved with copay coupons is the threat of Federal False Claims Act suits brought by private parties.  A Bloomberg BNA story, “Sebelius: ACA Exchange Plans Are Not ‘Federal Health Care Programs’” (Oct. 31, 2013) (subscription) quotes Arnold & Porter attorney Kirk Ogrosky as saying the HHS decision “simply opens the door to coupons in exchanges, but it also signals that relator’s counsel are free to file False Claims Act cases.”  The False Claims Act gives a significant incentive to private parties to file qui tam, or whistleblower, suits even when government agencies may not be interested in doing so.  As an example, on November 4, 2013, the Justice Department announced that pharmaceutical manufacturer Johnson & Johnson would pay $2.2 billion to resolve criminal and civil liability and that whistleblowers would receive nearly $168 million from that.

In what appears to be a belated recognition of the adverse implications for health insurance underwriting resulting from the Sebelius letter, the Centers for Medicare and Medicaid Services (part of HHS) on November 4 released guidance encouraging health insurance issuers to reject support of cost-sharing payments by commercial entities.  While not specifically mentioned in the CMS guidance, the discouraged practices clearly include drug company copay coupons:

The Department of Health and Human Services (HHS) has broad authority to regulate the Federal and State Marketplaces (e.g., section 1321(a) of the Affordable Care Act). It has been suggested that hospitals, other healthcare providers, and other commercial entities may be considering supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces. HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discourages this practice and encourages issuers to reject such third party payments. HHS intends to monitor this practice and to take appropriate action, if necessary.

We would not be surprised to see the HHS Inspector General and/or Congressional committees inquire into the decision process behind the Sebelius letter.


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The last article will talk about the Obama administration 'fighting' what we all know will be the result of PHARMA amassing huge wealth through global markets-----buying off any market-mechanism that will take market share away from big PHARMA.  Obama and neo-liberals took PHARMA out of the health reform issue by making sure none of the reform hurt PHARMA and indeed, these corporations will be cashing in big time as the world's citizens are soaked for the very life-saving drugs we have all been used to accessing.

The number of people made unable to access ordinary PHARMA will be in the hundreds of millions if not a billion and many of those will be right here in the US.  This article on TPP talks of how the drug distribution in developing worlds will change but remember-----

OBAMA AND NEO-LIBERALS HAVE TPP SITTING THERE AND NEO-LIBERALS IN STATES LIKE MARYLAND ARE ALREADY PASSING THE LAWS THAT ALLOW ALL OF THESE TPP REQUIREMENTS BE MET.

This is what Maryland's Sharfstein and Barbot have been doing as head of Maryland and Baltimore Health Departments.....creating the structures that will deliver this tiered level of access and the third world clinic care/home health care that will handle people dying from lack of access to ordinary care.  Johns Hopkins has built an entire global health tourism system on the backs of Baltimore citizens lack of access from stolen Medicare and Medicaid leaving longevity inequity of 30 years.  This is what the Affordable Care Act makes standard all across America.

THOSE 'COST SAVINGS' FROM BUNDLED PAYMENTS MEANS YOU AND I WILL BE NICKEL AND DIMED TO DEATH IN THE PURSUIT OF MAXIMIZING PROFIT.

As Obama uses the Federal legal system to 'fight in court' what we all know corporations with increasing size and wealth will do-----Obama is pushing to fast-track the TPP which he has spent his entire time in office working with corporations to write.  Bush and neo-cons started TPP and Obama and neo-liberals are trying to finish the deal. 

WE DON'T KNOW WHAT IS IN TPP SHOUT YOUR DEMOCRATIC INCUMBENT!  THE ENTIRE AFFORDABLE CARE ACT BUILDS THE STRUCTURES TO INSTALL TPP FOR GOODNESS SAKE AND YOUR POLS KNOW IT.


The Trans-Pacific Partnership and Public Health

The TPP would provide large pharmaceutical firms with new rights and powers to increase medicine prices and limit consumers' access to cheaper generic drugs. This would include extensions of monopoly drug patents that would allow drug companies to raise prices for more medicines and even allow monopoly rights over surgical procedures. For people in the developing countries involved in TPP, these rules could be deadly - denying consumers access to HIV-AIDS, tuberculosis and cancer drugs.

The TPP would establish new rules that could undermine government programs in developed countries. The TPP would control the cost of medicines by employing drug formularies. These are lists of proven medicines that the government selects for use by government health care systems. Lower prices are negotiated for bulk purchase of such drugs and new medicines that are under monopoly patents are not approved if less expensive generic drugs are equally effective. Drug firms would be empowered to challenge these decisions and pricing standards. In the United States, these rules threaten provisions included in Medicare, Medicaid and veterans' health programs to make medicines more affordable for seniors, military families and the poor.

TPP would empower foreign pharmaceutical corporations to directly attack our domestic patent and drug-pricing laws in foreign tribunals. Already under NAFTA, which does not contain the new rules proposed for TPP, drug firm Eli Lilly has launched such a case against Canada, demanding $100 million for the government's enforcement of its own patent standards. 

The TPP would also empower foreign corporations to directly challenge domestic toxics, zoning, cigarette and alcohol and other public health and environmental policies to demand taxpayer compensation for any such policies that undermine their expected future profits. Often initiatives to improve such laws are chilled by the mere filing of such an "investor-state" case. In other instances, countries eliminate the attacked policies. For instance Canada lifted a ban on a gasoline additive already banned in the U.S. as a suspected carcinogen after an investor attack by Ethyl Corporation under NAFTA. It also paid the firm $13 million and published a formal statement that the chemical was not hazardous.



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How do you end the availability of generics?  You create massively wealthy global PHARMA corporations that can afford to buy out all deals to form generic-producing companies.  ARE YOU SURPRISED THAT THIS IS ALREADY HAPPENING?  How have large corporations always gained market share-----by stamping out the competition.  So, big PHARMA sees a group of business people planning to create a generic manufacturing of a brand name drug and simply pay them not to.

That is what is happening all over the world.  So, when the Affordable Care Act sends more money to funding generic medication for the American people at the same time they know the consolidation of the health industry will give such power to these global health systems as to eliminate the production of generics-----THEY ARE LYING TO YOU AS TO THE INTENT OF THE ACA.

One more point with what is called 'biologics'.  For those noticing a corporation like Johns Hopkins now having a BIOTECH campus attached to its campus......this is the patent pipeline to new PHARMA that will hit the market.  ACA allows 'biologics' to hit the market with little FDA oversight or clinical trial requirements.  It will fast-track what will be multiple versions of 'generic' protein-based PHARMA allowing a corporation like Johns Hopkins to hit the market with drug after drug having no real value but earning money simply through winning market share with marketing.  All of this is completely without value to society----it is simply happening to allow Johns Hopkins to make a slight change in PHARMA formula to patent and sell. All of the manipulation of the drug market with the few methods I shared today will explode and the quality of drug most people will receive will deteriorate.  The most current drugs will be unattainable for most and the availability of what will be called 'generic' will be limited to PHARMA that is so old-----as to have no efficacy.



ALL OF MARYLAND POLS KNOW THIS IS WHAT IS IN STORE AND THEY ARE PASSING ALL THE LAWS NECESSARY AND MARYLAND IS BUILDING ONE OF THE MOST PROFIT-DRIVEN SYSTEMS IN THE NATION.

Court: Can drug companies pay to delay generics?

By JESSE J. HOLLAND and LINDA A. JOHNSON March 24, 2013 11:51 PM WASHINGTON (AP) --

Federal regulators are pressing the Supreme Court to stop big pharmaceutical corporations from paying generic drug competitors to delay releasing their cheaper versions of brand-name drugs. They argue these deals deny American consumers, usually for years, steep price declines that can top 90 percent.

The Obama administration, backed by consumer groups and the American Medical Association, says these so-called "pay for delay" deals profit the drug companies but harm consumers by adding 3.5 billion annually to their drug bills.

But the pharmaceutical companies counter that they need to preserve longer the billions of dollars in revenue from their patented products in order to recover the billions they spend developing new drugs. And both the large companies and the generic makers say the marketing of generics often is hastened by these deals.

The justices will hear the argument Monday.

Such pay-for-delay deals arise when generic companies file a challenge at the Food and Drug Administration to the patents that give brand-name drugs a 20-year monopoly. The generic drugmakers aim to prove the patent is flawed or otherwise invalid, so they can launch a generic version well before the patent ends.

Brand-name drugmakers then usually sue the generic companies, which sets up what could be years of expensive litigation. When the two sides aren't certain who will win, they often reach a compromise deal that allows the generic company to sell its cheaper copycat drug in a few years — but years before the drug's patent would expire. Often, that settlement comes with a sizeable payment from the brand-name company to the generic drugmaker.

Numerous brand-name and generic drugmakers and their respective trade groups say the settlements protect their interests but also benefit consumers by bringing inexpensive copycat medicines to market years earlier than they would arrive in any case generic drugmakers took to trial and lost. But federal officials counter that such deals add billions to the drug bills of American patients and taxpayers, compared to what would happen if the generic companies won the lawsuits and could begin marketing right away.

A study by RBC Capital Markets Corp. of 371 cases during 2000-2009 found brand-name companies won 89 at trial compared to 82 won by generic drugmakers. Another 175 ended in settlement deals, and 25 were dropped.

Generic drugs account for about 80 percent of all American prescriptions for medicines and vaccines, but a far smaller percentage of the $325 billion spent by U.S. consumers on drugs each year. Generics saved American patients, taxpayers and the healthcare system an estimated $193 billion in 2011 alone, according to health data firm IMS Health.

  But government officials believe the number of potentially anticompetitive patent settlements is increasing. Pay-for-delay deals increased from 28 to 40 in just the last two fiscal years and the deals in fiscal 2012 covered 31 brand-name pharmaceuticals, Federal Trade Commission officials said. Those had combined annual U.S. sales of more than $8.3 billion.

The Obama administration argues the agreements are illegal if they're based solely on keeping the generic drug off the market. Solicitor General Donald Verrilli, speaking at Georgetown Law School recently, noted that once a generic drug gets on the market and competes with a brand-name drug, "the price drops 85 percent." That quickly decimates sales of the brand-name medicine.

"These agreements should actually be considered presumptively unlawful because of the potential effects on consumers," Verrilli said.

In the case before the court, Brussels, Belgium-based Solvay — now part of a new company called AbbVie Inc. — reached a deal with generic drugmaker Watson Pharmaceuticals allowing it to launch a cheaper version of Solvay's male hormone drug AndroGel in August 2015. Solvay agreed to pay Watson an estimated $19 million-$30 million annually, government officials said. The patent runs until August 2020. Watson, now called Actavis Inc., agreed to also help sell the brand-name version, AndroGel.

Actavis spokesman David Belian disputed the government's characterization of the agreement with Solvay. Belian said that in addition to licensing agreement over Solvay's Androgel patents, Watson was being compensated for using its sales force to promote Androgel to doctors.

AndroGel, which brought in $1.2 billion last year for AbbVie, is a gel applied to the skin daily to treat low testosterone in men. Low testosterone can affect sex drive, energy level, mood, muscle mass and bone strength.

The FTC called the deal anticompetitive and sued Actavis.

The 11th U.S. Circuit Court of Appeals in Atlanta rejected the government's objections, and the FTC appealed to the Supreme Court.

The federal district and appellate courts both ruled against the government, AbbVie, which is based in North Chicago, Ill., said. "We are confident that these decisions will be upheld by the Supreme Court."

The Generic Pharmaceutical Association's head, Ralph Neas, said the settlements are "pro-consumer, pro-competition and transparent." He said every patent settlement to date has brought a generic drug to market before the relevant patent ended, with two-thirds of the new generic drugs launched in 2010 and 2011 hitting the market early due to a settlement.

"By doing what the FTC wants, you're going to hurt consumers rather than help them," said Paul Bisaro, CEO of Actavis of Parsippany, N.J.

Bisaro said consumers will save an estimated $50 billion just from patent settlements involving Lipitor, the cholesterol-lowering drug made by Pfizer Inc. of New York that reigned for nearly a decade as the world's top-selling drug.

Lipitor's patent ran until 2017, but multiple generic companies challenged it. Pfizer reached a settlement that enabled Actavis and a second company to sell slightly cheaper generic versions starting Nov. 30, 2011 and several other generic drugmakers to begin selling generic Lipitor six months later. The price then plummeted from Pfizer's $375 to $530 for a three-month supply, depending on dosage, to $20 to $40 for generic versions.

Because generic companies tend to challenge patents of every successful drug, the FTC's position would impose onerous legal costs on brand-name drugmakers and limit their ability to fund expensive research to create new drugs, said the Pharmaceutical Research and Manufacturers of America, which represents brand-name drugmakers.

According to the 2010 RBC Capital Markets study, when trial victories, settlements between drugmakers and dropped cases are combined, generic companies were able to bring their product to market before the brand-name drug's patent expired in 76 percent of the 371 drug patent suits decided from 2000 through 2009.

Consumer, doctor and drugstore groups have lined up to support the Obama administration in this case.

"AARP believes it is in the interest of those fifty and older, and indeed the public at large, to hasten the entry of generic prescription drugs to the marketplace," said Ken Zeller, senior attorney with the AARP Foundation Litigation. "Pay-for-delay agreements such as those at issue in this case frustrate that public interest."

The American Medical Association, the giant doctors' group, believes pay-for-delay agreements undermine the balance between spurring innovation through patents and fostering competition through generics, AMA President Dr. Jeremy A., Lazarus said. "Pay for delay must stop to ensure the most cost-effective treatment options are available to patients."

Drugstores also believe pay-for-delay deals "pose considerable harm to patients because they postpone the availability of generic drugs which limits patient access to generic medications," said Chrissy Kopple of the National Association of Chain Drug Stores.

Eight justices will decide this case later this year. Justice Samuel Alito did not take part in considering whether to take this case and is not expected to take part in arguments.

MOVING MOST PEOPLE TO MEDICAID-LEVEL ACCESS TO HEALTH CARE WHILE DEFUNDING AND DISMANTLING MEDICAID........WHY ARE YOU SHOUTING TO EXPAND MEDICAID WHEN WE NEED TO DEMAND EXPANDED AND IMPROVED MEDICARE FOR ALL?


As you see below Obama and neo-liberals are setting the stage for ending Medicare and Medicaid with private state systems that will be the recipient of all public health and corporate health plan populations---from entitlements to Veterans Admin to labor union benefits.  The bundling of payments with gutted funding is starting the dismantling of standard levels of care for all in each of these programs moving to income level and the ability to buy private insurance.  The next step will be-----Block Grants.  As I said, Obama's HHS appointment is on record for thinking block grants are the most 'effective' dispensation of Federal funds for public health care.  As we see as well, when funds are sent to the states ----equal protection, access, and accountability disappear.  Maryland is one of the worst in Medicare and Medicaid fraud and corruption and health disparity because of the handling of Federal funds in this block grant fashion free from Federal Medicare oversight.

Two years ago, neo-liberal pundit EJ DIONNE of the Washington Post mocked the American people by saying that those wanting single-payer will be getting it.  He means of course that over 80% of Americans will have been moved to a Medicaid or uninsured status in little over a decade if Affordable Care Act is allowed to continue.  Think how much income a Veteran has.....most labor union employees now that their wages are being slashed.....how much income/wealth seniors have after the decade of massive corporate fraud hit retirement wealth.  If we go to an income-based health insurance system which is what these tiered-health systems are.....over 80% will receive only preventative care and fall into these third world clinic-level of care.  So, shouting out for Expanded Medicaid is a mockery of what most citizens in America have paid into this Medicare Trust and whose taxes paid over decades funding all of the health research and development that neo-liberals and neo-cons are trying to deny access to.  Just because you are poor now as a result of a Bains Capital attack on the US economy-----doesn't mean you were not middle-class most of your life and deserve Medicare/VA benefits/Medicaid that provides basic medical access.

Do not fall for the bells and whistles of 'donut holes' and 'coverage for people with pre-conditions'.....children stay on their parents plan until 27......WHO WILL HAVE A PLAN?  The goal of Affordable Care Act is maximizing profit and bells and whistles will not last long.

DEMAND EXPANDED AND IMPROVED MEDICARE FOR ALL.  THIS WILL ASSURE NO MATTER THE LOSS OF LABOR BENEFITS, VA BENEFITS, OR REAL HEALTH COVERAGE WITH MEDICAID----THAT EVERYONE WILL RECEIVE THE LEVEL OF CARE THEY NEED AND DESERVE.

IT IS ALL PAID BY SIMPLY ENDING FRAUD, CORRUPTION, AND PROFITEERING IN THE HEALTH INDUSTRY....EASY PEASY.


Savings in Medicaid Series Increase Detection and Prevention of Fraud, Waste and Abuse

Issue Defined

Fraud, waste and abuse plague the healthcare industry and account for hundreds of billions of dollars lost annually, affecting taxpayers, the Medicare and Medicaid programs and all of their stakeholders. Although there is increased awareness, as well as action being taken, more can be done to detect and prevent fraud, waste and abuse.


Remember-----if you think it is fine for the poor to die without accessing basic medical procedures-----we have an economic crash coming soon that will send even more of what is left of the American middle-class into poverty so you, your children, or grandchildren may be those poor no longer accessing basic health care.

As you see, block granting has been sounded rejected by the American people and yet-----all of the movement in health reform by Obama and Congressional neo-liberals---and indeed, here in Maryland----is to block grants.

Medicaid Block Grants: A Zombie Idea With Lipstick in Texas

Posted: 04/09/2013 5:06 pm  Huffington Post


The latest proposal to block grant Medicaid in Texas is a terrible one for the state, its children, people with disabilities, and the elderly. Unfortunately, this bad idea, which just never seems to die, is once again being trotted out by Texas governor Rick Perry and his friends at the Texas Public Policy Foundation.

Federal block grants are, by definition, an arbitrarily capped amount of federal funding that go to states in the form of a lump sum payment and fail to adjust for population growth, economic changes, public health crises, or natural disasters such as hurricanes, tornadoes, etc.

Thus, states with growing populations, such as Texas, or states often in the pathway of natural disasters, such as Texas, or states with a disproportionate share of low wage jobs, such as Texas, would be most negatively impacted by a federally-imposed block grant. As need increases due to any of these factors, block grants and federal assistance are, by definition, unresponsive and unhelpful. States would be left facing the full brunt of any calamity or crisis.

Looking to protect the states from the problems inherent in their block grant proposal, former Congressman Dick Armey and former State Rep. Arlene Wohlgemuth argued in a Politico op-ed on April Fools' Day, "Once a block grant is in place, Texas should fundamentally transform Medicaid from a defined benefit program to a defined contribution program for most eligibility groups. This would undoubtedly lead to cost savings and a more sustainable system over the long term. With skin in the game, and without an unlimited guarantee of state and federal funds, Medicaid enrollees would be more efficient in their use of health care and more engaged as consumers."

Put another way, states would not have to worry because any costs above the per-determined and federally-imposed arbitrary limit in the block grant would simply be shifted to low-income children, the disabled, and the elderly -- the very people that Medicaid is intended to protect. Asking low-income children, the disabled, and the elderly to put "skin the game" when need is increasing and support is capped will lead to one outcome: health care rationing.

Since block grants are arbitrarily capped, federal support would no longer adjust for changes in need or population and this would particularly be a disaster to Texas because it is one of the fastest growing states in the country. In fact, between 2000 and 2010, the number of children across the entire country increased by 1.9 million. But, in Texas alone, the number of children increased by 979,000 -- which is more than half of all the growth in the combined 50 states and the District of Columbia.

Moreover, since block grants fail to adjust appropriately for changes in need, current inequities and disparities are permanently locked into place and often expand. For Texas, which already starts with the 2nd highest uninsured rate for children in the country, the situation would get worse with the federal government cutting back and capping its support to Texas despite its rapidly growing population.

Underscoring this very problem, proponents of Medicaid block grants, such as the Texas-based National Center for Policy Analysis (NCPA), often cite the Temporary Assistance for Needy Families (TANF) block grant as a model for Medicaid "reform."

However, when TANF was converted to a block grant structure in 1996, Texas initially received just 31 percent of the national average in the amount of federal support per child in poverty. Rightfully so, the state was deeply concerned the block grant would lock in this inequity forever. Consequently, Texas Senator Kay Bailey Hutchison attempted to negotiate a more favorable formula change to help Texas. However, since block grants are set at an arbitrarily capped amount, any increase for Texas would led to reductions to other states so she was unsuccessful. Instead, to get her support, small Supplemental Grants were approved with the intent of reducing the inequities among states.

However, population growth quickly outstripped the small adjustment for Texas. Even worse, the Supplemental Grants were allowed to expire in 2011. As a result, today the states receive the same level of federal TANF funding they initially received in 1996 without any adjustments for population or economic changes. As a result, inequities have increased and Texas now receives less than 26 percent of the average level of federal spending per child in poverty. In fact, in 2012, Texas received just $294 per child in poverty from the federal TANF block grant compared to the $2,782 per child in poverty that New York received.

For Texas, block grants only make sense if you think that the children of New York deserve 9.5 times more federal support per child than what Texas receives for its children and think that disparity should also increase over time, as it has in TANF. Although I doubt that any Texan would approve of that incredible and growing disparity in federal funding, that would be the "pig in the poke" that Texas would be buying into if it agreed to a Medicaid block grant as touted by TPPF and NCPA.

Incredibly, TPPF clearly recognizes the inherent unfairness in such block grant formulas. As they acknowledge in their ironically-named report Save Texas Medicaid: A Proposal for Reform, "Determining the amount of the block grant based on historical funding presents a number of inequalities. Medicaid programs vary between the states, such that states with higher health care costs get more federal funding. In addition, some states have negotiated more favorable waiver arrangements than others, and Disproportionate Share Hospital (DSH) payments reflect historical use rather than rational policy choices."

Again, for Texas, a block grant would lock in and exacerbate those inequities. So, how would TPPF address this issue that they recognize is a problem? They would not. As the report reads, "Nonetheless, basing the initial block grant amount on historical spending is the most acceptable method because it represents the political status quo."

Interestingly, the solution to this inequity in their "reform proposal" is to adhere to the "political status quo" even if this "solution" is detrimental to Texans and reflects "historical use rather than rational policy choices." At least TPPF admits it is not rational.

However, in addition to being really poor policy, it is also poor politics. In fact, with respect to the politics of cutting and capping health coverage to children, former State Rep. Arlene Wohlgemuth should know better after having led the effort in the Texas Legislature to cut 147,000 children off of coverage in the Children's Health Insurance Program (CHIP). Despite beginning her subsequent 2004 political race for Congress with a lead in the polls, Wohlgemuth was defeated by Rep. Chet Edwards after he ran a devastating ad about the impact of Wohlgemuth's efforts to slash children's health coverage.

In a country as wealthy as ours, with the best medical care in the world if you can afford it, the American people do not think we should be not be threatening and rationing the health care of our children, seniors, and people with disabilities. Medicaid provides long-term care to millions of seniors, helps Americans with disabilities live independently, and enables millions of children to see a doctor. In fact, a Bloomberg national poll found that over three-quarters of the American public oppose cutting Medicaid and that it is the least popular option of all for deficit reduction.

In short, block granting Medicaid is a poorly conceived and arbitrary form of health rationing that in opposed by the American people and has been defeated on a bipartisan basis time-and-time again. Putting a new picture on the cover of this latest proposal does not change that fact. As former Texas governor Ann Richards would say, "You can put lipstick on a pig, but it is still a pig."

Rather than, once again, trotting this zombie idea to ration the health care of others: politicians (both current and former) should test the idea on themselves. Medicaid block grant proponents should first agree to cap and limit their own government insurance coverage. After such an experiment, they can then let us know whether they still consider health insurance for seniors, children, and people with disabilities should be rationed.

____________________________________________
As you see below the ACA has so many loopholes and special exceptions that the level of care always printed on the Medicaid page looks nothing like you think it should.  Most low-wage workers will fall into the 'skinny' category that is preventative care only.  This is what most Medicaid will look like.  So, people are being categorized as having health insurance whether Medicaid or Bronze level plan----but they are not accessing health care.  America has had since Reagan/Clinton the worst health care access in the developed world----the Affordable Care Act takes that lower. 

Remember, the Affordable means the cheapest care for the most profit.

Why Health Law's 'Essential' Coverage Might Mean 'Bare Bones'

By Jay Hancock

KHN Staff Writer

Aug 25, 2013

It came as a surprise to some that the Affordable Care Act seems to allow large employers to offer health insurance that pays for preventive care and not much else. Check out our story on "skinny" plans quoting a consultant saying that for employers with 50 or more workers, “the feds imposed no minimum standard on how skimpy that coverage can be other than to say, in essence, it’s got to be more robust than a dental plan or a vision plan." (The Wall Street Journal broke the story here in May. Subscription required.)

Retailers, restaurant chains and temporary staffing companies are said to be interested.

But how can a law praised for expanding coverage -- one that includes an "employer mandate" to offer "minimum essential coverage" -- allow companies to offer insurance that might not even cover hospitalization?

Take a walk through the ACA weeds to see why.

First of all, there is no outright ban on skinny plans -- even after the employer mandate kicks in in 2015. Instead, large employers -- those with 50 or more full-time employees -- run the risk of fines only if the coverage doesn't conform to ACA rules. The regulations published so far, however, seem to allow skinny plans with a penalty that many employers may choose to pay because it is less costly than offering fuller coverage.

There are two fines in the health law for large employers failing to offer adequate coverage. First, any company that does not offer "minimum essential coverage" is liable for a $2,000-per-worker penalty (minus the first 30 workers), triggered when at least one employee enrolls in subsidized coverage in the online marketplaces known as exchanges.

But what is minimum essential coverage? Not as robust as you might think. To start, don't confuse it with "essential health benefits," including maternity benefits and prescription drugs, that must be included in plans sold to individuals or small employers.

If health insurance is merely sponsored by an employer, it passes one test for minimum essential coverage.

Story Components

• Bare Bones Health Plans Expected To Survive Health Law
• Why Health Law's 'Essential' Coverage Might Mean 'Bare Bones'

Now how good does that employer insurance have to be? The regulations are obscure, defining minimum essential coverage largely in terms of what it is not. For example, "limited-scope dental or vision benefits" are not minimum essential coverage. Nor is "coverage only for a specified disease or illness."

Neither the law, nor the regulations say much about what minimum essential coverage offered by a large employer is. As a result, many experts believe large employers can shield themselves from the $2,000 penalty by offering a plan that covers the health law's required preventive care, but still leaves workers vulnerable to thousands in bills if they're hospitalized. If employees sign up for such plans, which may cost as little as $50 a month, they would also be protected from health-law penalties levied on individuals without coverage.

The health law also fines employers that don't offer "minimum value" in their health plans, says Alden Bianchi, a Boston-based benefits and compensation lawyer. Skinny coverage flunks that test, based on regulations that measure minimum value against "benchmark plans" in each state, Bianchi said. But the employer penalty is only $3,000 for each worker enrolling in subsidized exchange coverage. That's likely to be much less than the fine for not offering minimum essential coverage, which is $2,000 for nearly every employee in the company, even if most don't buy policies in the exchanges.

But what about other rules governing health benefits? What about the part of the health law that bans insurers from cutting off benefits at a certain dollar level? Not a problem for skinny plans. Unlike the "mini-med" plans in common use before the law was passed, they don't impose a dollar cap; they merely exclude large categories of care, which also keeps down costs.

What about new rules limiting out-of-pocket expenses for consumers? For 2014, your plan can't make you pay more in co-pays and deductibles than $6,350 for individuals and $12,700 for families. (That may temporarily be higher if your employer has separate administrators for drug benefits and doctors and hospitals.) Skinny plans pass the test again. Out-of-pocket caps are for covered care only, and skinny plans don't cover much care.

What about restrictions on self-insured employers (the large majority of large companies are self-insured) offering a rich-benefit plan to managers and a limited-benefit plan to hourly workers? Skinny plans survive this one, too, says Ed Fensholt, a senior vice president at Lockton Cos., a large insurance broker. These non-discrimination rules contain exceptions for high-turnover workers, he said. And they require employers only to offer the management plan to hourly workers, not for the workers to enroll.

"That plan would be priced at a place where relatively few rank and file employees would want it," Fensholt says. "And then they'd offer the skinny plan to the rank and file."

When asked about the situation, the Obama administration said consumers lacking good coverage "can enter into the marketplaces and choose a health insurance option that works for them."

Bianchi, who represents large employers, says the people who wrote the law intended to give companies a bare-bones option.

"The ability to offer such plans is a result of conscious policy decisions by Congress, as implemented by the regulators," he wrote in an industry brief.

The Cato Institute's Michael Cannon, on the other hand, suspects the administration "had no idea what they were doing," as he wrote on the libertarian think tank's blog.


____________________________________________
Raising the level of Medicaid eligibility when Medicaid is simply a preventative checkup/clinic care is not a boon for most US citizens who used to have labor union contracts and benefits.  I have shown that all those health plans lost in corporate bankruptcies are now sitting in a Federal agency and the people once having strong health benefits are getting little over Medicaid-level care.  One the the deals made in these bankruptcy agreements was that corporations would pay into this Federal agency program -----but they are not so the funding is not there and hundreds of billions of dollars in unfunded need is there.  Neo-liberals and neo-cons have no intention of using the oversight and accountability needed to get that money -----and the pension fraud that hit this agency and all pensions----ALL OF WHICH WOULD LEAVE MANY AMERICAN PEOPLE WITH DECENT HEALTH COVERAGE.  ALL WILL BE LEFT TO MEDICAID-LEVEL CARE.


Most doctors will not be seeing Medicaid patients and in fact it is nurse practitioners who are being sent to clinics to replace the doctor.  I am definitely for nurse practitioners----but they cannot provide any medical service other than preventative care.

Remember, everyone used to be able to go to the hospital and receive treatment for any ailment----so the poor had access to most care needed.  So to pretend this Medicaid expansion is about giving the poor more care----IS A LIE....IT IS DENYING THEM BASIC MEDICAL CARE. 

THE INSURANCE MANDATE WAS NEVER ABOUT FUNDING THIS EXPANDED CARE----IT WAS SIMPLY MEANT TO END PUBLIC HEALTH AND EXPAND PROFITS.



Attention Medicaid Patients: The Doctor Won't Be Seeing You

  With its expansion of Medicaid eligibility, the Affordable Care Act (a.k.a. Obamacare) was supposed to go a long way towards providing healthcare coverage to millions of uninsured Americans. That accomplishment was dealt a large blow by the Supreme Court, when it forbade the federal government from requiring states to expand Medicaid coverage. Nevertheless, many states plan to offer Medicaid to anyone with incomes at or below 138% of the Federal Poverty Limit (FPL). And more states might follow suit over time, under pressure from the healthcare industry, which likes its customers to be paying customers.

However, even if Medicaid coverage expands under Obamacare, a big potential problem remains—many physicians will be unwilling to care for Medicaid patients. But how many physicians and which ones?

   A July study in Health Affairs estimated the percent of physicians from a wide range of specialties who were unwilling to take on new Medicaid patients in 2011 and 2012. What specialty would you guess was least likely to accept new Medicaid patients?

If you are like me, you guessed some high-paying procedural subspecialty, like orthopedic surgery or ophthalmology, where the physicians are accustomed to high fees and well-paying patients. In the case of orthopedic surgery, you would not have been too far off—40% of these physicians were unwilling to make new patient visits available to Medicaid recipients. On the other hand, only 18% of ophthalmologists were unwilling to see Medicaid patients.

The “winner” was a surprise to me however: it was psychiatrists. A full 56% of them were not open to seeing new Medicaid patients. I don’t know why this is such a high number. Perhaps Medicaid enrollees have a higher than average rate of mental illness, and thus account for a disproportionate number of psychiatric patients, maxing out their ability to care for those patients. Or perhaps Medicaid fees are particularly low for psychiatric care, relative to other forms of care. I’d be curious to see if any of you readers have any other ideas.

Which doctors do you think were most likely to accept new Medicaid enrollees? Once again, I was surprised by the answer: it was cardiologists. Only 9% were unwilling to take on new Medicaid patients.

I am not knowledgeable enough about Medicaid to understand what is going on here. I would love to hear ideas from all of you.

But meanwhile, I leave you with a simple take home point: healthcare coverage does not equate with access to healthcare. Physicians have to be willing to see patients. And if Medicaid does not pay well enough to incentivize physicians to see Medicaid patients, or if it is too slow to pay off claims, or if some other barrier stands in the way of helping these patients receive needed medical care—then we need to address those barriers. It is no use to obtain healthcare coverage that doesn’t get you healthcare!
________________________________________
This poll shows Medicaid numbers before ACA----the numbers will soar as corporations drop plans and the working and middle-class become unable to meet insurance co-pays and deductibles.  Do you know the growing population of people on Medicaid?  College graduates left unemployed by global corporations deliberately stagnating the economy.

• May 25, 2011, 9:48 AM ET

Kaiser Poll: Half of Americans Report Personal Tie to Medicaid

• By Katherine Hobson

Kaiser’s latest health tracking poll focuses on Medicaid — and some of its findings may surprise you. About half (51%) of the 1,203 adults surveyed report a personal connection with the federal-state insurance program for low-income Americans, defined as receiving benefits themselves or having a friend or family member who has done so.

TALKING ONE MORE TIME FOR NOW ON THE DISASTER OF PRIVATIZING PUBLIC HEALTH THROUGH PRIVATIZING UNIVERSITIES AND THE EFFECTS OF AFFORDABLE CARE ACT.  WE CAN SEE TRANS PACIFIC TRADE PACT IN THE WAY THE PRIVATIZED PATENT SYSTEM AND THE LACK OF FDA OVERSIGHT IS MAKING OUR HEALTH SYSTEM DANGEROUS!

ALL OF MARYLAND CANDIDATE'S FOR GOVERNOR WILL CONTINUE THIS GLOBAL CORPORATE STRUCTURE FOR HEALTH CARE EXCEPT CINDY WALSH FOR GOVERNOR



I listened to a NPR------corporate media all the time----report on the escalating problem of medical procedures and devices passing FDA approval and failing and sometimes killing the American people.  The numbers are soaring as the FDA is now working to send these products to market for profit and allowing the failures to be discovered after the fact by harming the citizens of America.  This NPR article looked at one medical procedure that was approved by the FDA after a supposed 'clinical trial' of a few hundreds of people.  The entire process looked to be filled with false data and sketchy connections with who and how the medical research was conducted and if any of the results were reproducible or if the efficacy was real.

  ERGO-----THE ENTIRE PUBLIC HEALTH CLINICAL TRIAL PROCEDURE IS BEING DISMANTLED AND THE GENERAL PUBLIC WILL NOW BE THE TEST SUBJECTS.  IF HARM IS DONE-----TOUGH LUCK AND WE WILL ALLOW THE BAD MEDICAL PROCEDURE TO CONTINUE REGARDLESS IN ANOTHER FORM.

This is what a corporate state looks like and it is Trans Pacific Trade Pact already in action as Obama has filled his Federal agencies with the same kinds of people that Bush did-----people committed to global corporate control of all public policy.

THIS IS WHAT YOUR ELECTIONS FOR GOVERNOR AND MAYOR ARE ABOUT-----WE THE PEOPLE MUST WIN THESE ELECTIONS!

What is happening as well is that Obama and your neo-liberal Congress person sent hundreds of billions of dollars to higher education under the guise of building stronger education but what they are building are corporate university research facilities complete with patenting of research done at this university.  Most institutions receiving those hundreds of billions to build their corporate R and D?  Ivy League universities like Johns Hopkins.  What this policy does is make these universities corporations that receive tons of public taxpayer money to subsidize research in the guise of education while it is simply a patent machine for corporate R and D.  When you see BIOPARK outside of Johns Hopkins or University of Maryland Medical System in Baltimore (a quasi-institution, not public so they say)   ---you are seeing the public subsidizing with what is called education funding the profits of what are now corporations.

More important is combining this with the fact that the clinical trial structure and fast FDA approval of these patented procedures, devices, or medications that are simply rubber-stamped and you have ABSOLUTELY NO PUBLIC OVERSIGHT OF ANY OF THE HEALTH INDUSTRY ACTIONS.  Remember, universities----especially public universities ------were the one institutions charged with making sure the data and research of products protected the people.  These corporate structures built by neo-liberals like O'Malley and neo-cons like Erhlich are now doing just that.......creating an unaccountable and fraudulent system in our medical research structure.

OBAMA AND NEO-LIBERALS IN CONGRESS-----ALL MARYLAND POLS ARE NEO-LIBERALS------DELIBERATELY SENT MONEY TO BUILD WHAT THEY KNOW WILL HURT AND/OR KILL CITIZENS IN THE NAME OF CORPORATE PROFIT.

This is what Trans Pacific Trade Pact and the Affordable Care Act is all about.....consolidating the health industry into global corporate health systems that are deregulated and unaccountable and that will do harm without a second thought in pursuit of profit.  This is what the Maryland Health reform has done these several years under O'Malley and Rawlings-Blake in Baltimore-----created the structures to allow all this to happen and with no oversight or accountability structures.

SEE WHY CINDY WALSH FOR GOVERNOR OF MARYLAND AND HER PLATFORM MUST BE KEPT OUT OF THIS ELECTION????

'The 510(k) loophole

Although the FDA requests clinical data in about 10% of cases, one concern over the 510(k) system is that testing is insufficient and so products that are either unsafe or ineffective could be released to market'.

Please read below to the 510 loophole.....it has made the FDA just as the SEC----working for corporate interests against the people's interests.  That is what a corporate state does.

How does the FDA 'approve' medical products?

Thursday 20 February 2014 - 8am PST

Written by David McNamee  Medical News Today



  You may have seen medical products that claim to be "FDA cleared," "FDA registered," "FDA listed" or "FDA approved" - but what do these labels mean? You would be forgiven for feeling confused.

In this feature, we look at what the differences in Food and Drug Administration (FDA) classification actually mean, what you need to be aware of as a consumer and what the future holds for the regulation and classification of medical products in the US.

Though you may see labels on a wide variety of medical products - from implantable defibrillators to smartphone apps - bearing legends such as "FDA registered," in reality these claims are often disingenuous. But regulation over the correct terminology is rarely enforced.

Class 1, 2 and 3 In truth, the only products that the FDA specifically "approve" are drugs and life-threatening or life-sustaining "Class 3" medical technology (such as defibrillators). These are submitted to a rigorous review process called "pre-market approval" (PMA), to prove that the benefits of the products outweigh any potential risks to the health of the patient.


The only products that the FDA specifically "approve" are drugs and life-threatening or life-sustaining "Class 3" medical technology. Scientific evidence from clinical trials must be provided by the manufacturers demonstrating the safety and effectiveness of their product. Just 1% of products pass PMA.

Over-the-counter drugs are monitored by the FDA, but they are submitted to a less rigorous testing procedure, especially if they are assumed to be safe.

Vitamins, herbs and supplements are not tested by the FDA unless they are an active ingredient in a drug that requires FDA approval - so manufacturers of supplements are not allowed to claim that their products can treat any specific disease, only that they "promote health."

Despite this, some supplement companies are known to illegally claim their supplements are "FDA approved." It is thought that the FDA are unable to intervene in every instance due to limited resources.

Low-risk medical devices, such as stethoscopes and gauze, are known as "Class 1" and are exempt from FDA review.

"Class 2" medical devices are defined as not life-sustaining or life-threatening, though this category covers a wide spectrum of devices, from X-ray machines to some exercise equipment.

The level of scrutiny attached to Class 2 devices is much lower than Class 3. The devices do need FDA "clearance" before they can be marketed and sold, but rather than submit their products for clinical trial, the manufacturers are required instead to convince the FDA that their products are "substantially equivalent" to products that have been previously cleared by the FDA.

Substantially equivalent means that the device has the same intended use and approximate technical characteristics as an existing product.

Products that pass this clearance process may be referred to as "FDA cleared" or "FDA listed," but this is not the same as "FDA approved," which only relates to the prescription drugs and Class 3 devices that have passed PMA.

This approval method for Class 2 devices has been the subject of mounting controversy. The process is known as "510(k)" - named after its section in the law.

The 510(k) loophole

Although the FDA requests clinical data in about 10% of cases, one concern over the 510(k) system is that testing is insufficient and so products that are either unsafe or ineffective could be released to market.


Under 510(k), devices that have passed clearance, but have later been found dangerous or ineffective and are recalled, are not automatically removed from the FDA's list of cleared products. Another worry about this process is that the more "substantially equivalent" (but not identical) products are listed, the more a chain grows of FDA-cleared products that increasingly move away from the original product.

But perhaps the most concerning feature of 510(k) is that devices that have passed clearance, but then have later been found dangerous or ineffective and are recalled, are not automatically removed from the FDA's list of cleared products.

This is a loophole that allows any new products bearing the same faults to remain eligible for FDA clearance through 510(k).

In a 2012 report, the Institute of Medicine (IOM) recommended that 510(k) be replaced with an "integrated pre-market and post-market regulatory framework that effectively provides a reasonable assurance of safety and effectiveness throughout the device life cycle."

But these recommendations - though popular with consumer advocacy groups - were rejected by the FDA.

A congressman (now senator) for Massachusetts, Ed Markey, campaigned for the reform of 510(k) and proposed a 2012 bill to close the loophole.

But the bill was not passed. It received opposition from medical device manufacturers and members of Congress who claimed that the existing FDA review processes are already too time-consuming and unpredictable, compared with other countries, so inserting more safeguards and regulatory steps would have the effect of strangling innovation.

Medical News Today spoke to Dr. Michael A. Carome, director of the non-profit consumer rights organization Public Citizen's Health Research Group, about 510(k).

Dr. Carome cites a report that Public Citizen issued in 2012 highlighting "a concerted lobbying campaign intended to weaken the already lax regulatory oversight of medical devices."

"For example, in 2011 the medical device industry spent $33.3 million on lobbying, raising its total to $158.7 million since 2007. This lobbying campaign has been very successful and has generally drowned out calls for stronger medical device regulation from consumer advocates like Public Citizen."

Carome also sees a second obstacle in the FDA itself, "which has been very resistant to proposals to strengthen or replace the 510(k) system."

"The FDA seems beholden to the medical device industry and the mantra that promotion of 'innovation' is the most important goal in the regulation of medical devices," he adds.

More recently, Sen. Markey wrote to the FDA, appealing directly for them to reform 510(k).

Sen. Markey was satisfied with the FDA's response, announcing in December 2013 that database modifications proposed by the agency "will help decrease the dangers and increase the awareness of medical devices that may be made based on flawed models."

Dr. Carome feels, though, that the FDA's proposed measures "fail to adequately address the underlying flaws in the 510(k) premarket clearance process."

The central issue remains that new Class 2 medical devices found to be "substantially equivalent" to recalled but previously cleared devices are still obliged - by law - to be cleared by the FDA, despite whatever flaws the devices contain.

"The slightly improved transparency provided by FDA's revised database for 510(k)-cleared devices does not close this dangerous loophole in the existing law that threatens patient safety," Carome concludes.

But what are the Class 2 devices that have caused patient safety concerns?

Carome points to the DePuy metal-on-metal Articular Surface Replacement (ASR) hip implant - an "example of a medical device heavily promoted as being innovative and better than earlier types of devices."

In November 2013, DePuy - an orthopedics company owned by Johnson & Johnson - announced a $2.5 billion settlement to resolve more than 8,000 of 12,000 public liability claims filed in US courts after their metal-on-metal hip was recalled in 2010. The ASR was found to shed metallic debris as it wears, causing pain and injury to the patient.

The Myxo ring In 2008, a surgeon named Dr. Patrick McCarthy at Chicago's prestigious academic medical center, Northwestern Memorial Hospital, was found to be installing a device he had invented - the McCarthy Annuloplasty Ring - into the hearts of cardiology patients without the informed consent of the patients.


"If you are planning to receive a medical device in a US hospital, there is no way to confirm whether the device is FDA approved, investigational or registered," says Dr. Rajamannan. Concerned patients were even more alarmed when they discovered that the ring had also not been submitted to the FDA for review.

"There are no guideposts for us. You don't learn about this stuff in med school," McCarthy was quoted by the Chicago Tribune as saying, when questioned on why he had bypassed FDA approval.

The ring's manufacturer, a company called Edwards Lifesciences, later falsely claimed that the device was exempt from the 510(k) process and so did not require FDA clearance.

When a concerned colleague of McCarthy's, Dr. Nalini Rajamannan, contacted the FDA, an investigation was triggered, which ultimately saw the ring cleared for use - despite having already been sewn into the hearts of 667 patients.

But further controversy surrounded the FDA's clearance, which simply relied on a clinical study Dr. McCarthy himself had written as evidence that the ring - now rebranded "Myxo dETlogix" - was safe and effective.

Dr. Rajamannan - who was co-author on that study before withdrawing when she learned that the patients involved were not giving informed consent - later wrote a book detailing the controversy and continues to campaign on behalf of patients installed with the Myxo ring.

Speaking to Medical News Today, she says that the concerns over the Myxo device have still not been addressed by the FDA:

"The FDA has written a formal letter stating that they would not be investigating the matter any further. These heart valve rings that are being cleared under the 510k process for Edwards Lifesciences are associated with over 4,000 adverse events and over 645 deaths."

"The other major heart valve manufacturers have less than 20 events for their rings in the FDA database."

What does the future hold for FDA regulation? As we have shown in this feature, the confusion over the various stages of FDA "approval" and "clearance" is not limited to patients. These examples show that FDA classifications and processes can also - naively or wilfully - be misinterpreted by manufacturers and medical professionals.

The concerns from doctors, patients and consumer advocacy groups on the lack of regulation of medical products and the conflicts of interest within those regulatory processes remain.

Dr. Carome recommends that the IOM's 2012 guidelines be implemented and suggests that more of the Class 2 products sped through to market under 510(k) need to be reclassified as Class 3, for which the PMA process is much more stringent.

"Manufacturers do heavily promote their devices as being new and innovative, and many health care providers and patients believe that a 'newer' or 'innovative' device must be better," reasons Carome. "However, in most cases, there is no evidence that the newer medical devices are any better than older devices or other less-invasive treatments that don't involve a medical device."

"It is a real safety problem," agrees Dr. Rajamannan, who adds: "If you are planning to receive a medical device in a US hospital, there is no way to confirm whether the device is FDA approved, investigational or registered."

"The patients in the US are at major risk and the FDA is doing nothing to help the patients."
_______________________________________________
As I said, Maryland TV is plastered with injury law firms gathering patients that are victims of this horrendous system.  As we all know, the injury lawyers get all the money in the end and the patients are harmed for life.  This is what a third world nation looks like----citizens cannot even seek medical help without being fearful the procedures are happening in their interests and not for profit.

In Maryland, the Maryland Assembly has passed laws that make it as hard as possible for the public to seek justice in medical malpractice and it does not require medical malpractice insurance---meaning doctors prone to bad practices would love to come to Maryland.  NONE OF THESE POLICIES ARE DEMOCRATIC----YET MARYLAND IS CALLED A 'PROGRESSIVE' STATE.  It is a neo-liberal/neo-con state.




New Jersey Personal Injury Blog FDA Failed to Properly Test Medical Devices before Approval

By Blume Donnelly Fried Forte Zerres & Molinari
on March 9, 2011

CNN recently reported that a review of recall data from the U.S. Food and Drug Administration (FDA) found that the majority of the 113 Class III medical devices that were recalled between 2005 and 2009 for serious, life-threatening dangers, did not undergo the FDA’s more rigorous pre-market approval process, also referred to as “PMA.” Instead, the agency cleared the devices using a less stringent process known as the 510(k) process, under which clinical testing is not required. This discovery brings to light that many medical products that were given clearance, such as automated external defibrillators (AEDs), artificial hip joints, and heart valves, were marketed to and used on consumers without undergoing clinical testing in advance.

Under FDA policy, all Class III devices are required to undergo the PMA premarket approval process, including clinical testing, in order to determine if “sufficient valid scientific evidence” is found that the medical device is safe for its intended use.

However, a report from the Government Accountability Office in 2009 discovered that approximately 66 percent of all Class III devices were approved using the less demanding 510(k) process instead of the PMA because it was “less burdensome”. An additional study, published in the Journal of the American Medical Association’s Archives of Internal Medicine, found that approximately 71 percent of the 113 medical devices recalled between 2005 and 2009 were given approval through the 510(k) process.

Many believe the reasons for the shortcomings in testing are because the agency does not have the necessary funding and staff to conduct a clinical study for all medical devices requiring same. While a medical device’s manufacturer does pay for a fraction of the expenses related to a PMA approval, the majority of the cost falls to the FDA, which is under-funded. Choosing to approve a medical device under the 510(k) process is much less expensive.

The FDA has admitted that the 510(k) approval process needs to be toughened, and has stated it intends to take action to improve the process in 2011. Additionally, the FDA has stated it will evaluate all remaining Class III devices slated for the 510(k) process to determine if the device should undergo the PMA process. As a result, there may be dangerous medical devices on the market that have not received proper government approval.

If you believe that a defectively designed or manufactured medical device may have seriously affected your health or the health of a loved one, contact a New Jersey product liability attorney at Blume Goldfaden. Call 973-635-5400 to schedule a no-cost consultation with one of our lawyers.




____________________________________________________
Keep in mind that a republican Bush slashed funding for most Federal agencies as a way to make oversight and accountability go away.  So, when Obama makes an increase of 2-3% he is doing nothing towards rebuilding these agencies.  In fact, much of the funding that makes it to these agencies is simply lost in private outsourcing with all its fraud and corruption.

When they say 'it's the sequestration and the national debt' 

WE SAY----NO, IT'S THE FAILURE TO RECOVER TENS OF TRILLIONS OF DOLLARS IN MASSIVE CORPORATE FRAUD THIS LAST DECADE.

This funding status quo simply keeps our Federal agencies in a mode of 'doing no harm' to corporate profits.

STOP ELECTING NEO-LIBERALS!  DO YOU HEAR YOUR POLS SHOUTING TO BRING BACK TENS OF TRILLIONS OF DOLLARS IN CORPORATE FRAUD!  MARYLAND POLS LOVE FRAUD AND CORRUPTION SO THERE IS NOT A WORD

Once again republican think tanks are crying foul but they are the ones behind all of the dismantling of these agencies creating the fraud and corruption and loss of trillions of dollars.  Their figures are right---$900 billion from Medicare will be taken from the patient's care and not hospital profits.


Reaction to Obama's 2015 HHS funding:

Various health care providers and organizations have responded to the proposal, with many calling for increased funding for health-related agencies and initiatives.

The Federation of American Hospitals criticized proposed funding cuts to Medicare, with FAH President and CEO Chip Kahn saying they would "further threate[n] seniors' access to vital hospital services" and noting that both Republicans and Democrats oppose such reductions (Demko/Zigmond, Modern Healthcare, 3/4). According to National Journal, the group is hoping to persuade Congress against the cuts by touting a new study estimating over $900 billion in Medicare savings over the next 10 years through cost cutting resulting from changes to the way providers deliver care (Ritger, National Journal, 3/4).

American Hospital Association President and CEO Richard Umbdenstock said the proposal contained some "problematic policies" that would hurt hospitals' abilities to improve the health care system and place patients' at risk of losing access to services (Demko/Zigmond, Modern Healthcare, 3/4).

Kasey Thompson, president and chair of the Alliance for a Stronger FDA and vice president of policy, planning and communications for the American Society of Health-System Pharmacists, called for additional FDA funding, saying, "Given that FDA regulates about 25 cents of every dollar of the gross domestic product, it does not have enough money to fulfill its public health mission."

Alliance for a Stronger FDA Deputy Executive Director Steven Grossman added that the group plans to ask Congress for more FDA funding (Lee, Modern Healthcare, 3/4).

The proposed increase in NIH funding also generated backlash. Research! America President Mary Woolley in a statement said that the U.S. "simply cannot sustain [its] research ecosystem, combat costly and deadly diseases ... and create quality jobs with anemic funding levels that threaten the health and prosperity of Americans," adding, "These funding levels jeopardize our global leadership in science -- in effect ceding leadership to other nations as they continue to invest in strong research and development infrastructures" (Viebeck, "Healthwatch," The Hill, 3/4).




_____________________________________________________


This is how crazy things have gotten.  California is indeed ground zero for this university as corporation model starting with Stanford and now consuming all public universities.  Remember, California had the best education system in the world----I had the pleasure of attending California schools at all levels-----but this move to corporatize has ruined the entire higher education system and they are now creating the tiered higher ed as they are in Maryland with working and middle class being tracked into vocational K-career college.

This is critical to health care because these large universities whether public or private are the source of public protections for health.  If the data is corrupt at universities-----no one is watching the health corporations either.  So, if you think funding universities by making them corporations is a good idea----THINK OF ALL THE FACTORS CONNECTED TO THIS.

It is interesting to note that Governor Brown-----who will try to run for President as a 'progressive' on his old record as a real progressive in the 1970s---appointed Napolitano-----HEAD OF HOMELAND SECURITY WITH NO EDUCATION BACKGROUND as Chancellor of California Higher Education School System.

THE CONTINUED USE OF INSIDERS FILLING APPOINTED POSITIONS AT ALL LEVELS.

When they talk of 'start ups from this university research' they do not tell you that 9 times out of ten those start-ups that are successful are simply absorbed into global corporations.  IT IS A PIPELINE.  Keep in mind that these corporate universities sell this corporate structure as funding schools but it is this structure that has student tuition sky high subsidizing this research and patenting process.  Maryland has done the same to its universities as this article shows in California and it is where all public funding for education is now going.  Johns Hopkins has had so much money funneled to it from our Congress neo-liberals that it owns much of the land in Baltimore's downtown and city center and it is all simply businesses connected to Hopkins.  THIS IS HOW YOU BUILD A GLOBAL CORPORATION THAT CONTROLS A REGION----

Patent-reform legislation spurs controversy among universities

Tina Pai/Staff By Tahmina Achekzai

Last Updated April 28, 2014

In 1994, Michael Doyle, then the director of a computer lab at UCSF, patented software that allowed doctors to view embryos online — the first “interactive” application on the web.

A few years later, the University of California licensed a patent to a company Doyle created called Eolas, which, claiming rights to the idea of embedding interactive content on web pages, sued Microsoft in a multimillion-dollar lawsuit.

The university, a co-plaintiff in the case, took a $30.4-million cut in what is now widely regarded as a classic case of “patent trolling.”

This week, Congress is marking up legislation in hopes of combating patent trolls — companies that purchase patents not to commercialize a product but to reap licensing revenue.

The UC system holds nearly 4,000 U.S. patents that have led to thousands of inventions and hundreds of startup companies. The University of California leads the nation’s universities in patent development, but pending legislation may change that.

Politicians vs. trolls

Traditionally, researchers apply for patents that give them full ownership of their idea or invention and then sell the rights to outside companies, hoping to take their discoveries from the lab to industry. But when the inventions seem to have little hope for commercialization, “patent trolls” may step into the picture.

Trolls, more formally known as patent-assertion entities, will find and subsequently sue businesses they accuse of infringing patent rights. Serving as a middleman between inventors and businesses, trolls collect licensing fees, a portion of which the inventors may receive.

According to the 2013 White House Patent Assertion and U.S. Innovation Report, suits filed by patent trolls tripled from 2010 to 2012, at which point they comprised 62 percent of all patent-infringement cases.

Experts say that because it costs millions of dollars to ascertain what a patent covers, companies faced with these lawsuits may choose to settle rather than to fight.

In November, Sen. Patrick Leahy, D-Vt., introduced a bill hoping to increase transparency within the patent system and to curb the emerging trend of patent trolling.

The bill would require any patentee who has filed a lawsuit to disclose any financial interests. It also requires the Federal Trade Commission to exercise authority over the misuse of demand letters: notices to companies claiming restitution for breach of license.

Academic qualms

Though the legislation is designed to serve as a deterrent to patent trolls attempting to sue other parties, universities worry it will invariably impede their efforts to enforce their own patent rights.

Earlier this month, the Association of American Universities — of which the UC system is a part — signed a joint letter addressed to Leahy outlining its concerns. The letter was also signed by the Association of University Technology Managers, made up of representatives from “technology transfer” offices at many universities who guard university research.

“Much of the legislation that is currently under discussion in Washington goes far beyond what is necessary simply to prevent that abuse of the patent system,” said David Winwood, the vice president for advocacy at the Association of University Technology Managers.

Of particular concern among both universities and members of Congress is the possible addition of a fee-shifting provision, which would require the losing party in a lawsuit to cover fees and expenses incurred by the opposing party.

Carol Mimura, UC Berkeley’s assistant vice chancellor of intellectual property and research industry alliances, explained that the threat of incurring additional fees could discourage universities from filing lawsuits against actual infringers.

“The provision favors large, deep pockets, not the little guys,” Mimura said in an email. “Big companies and deep pockets create a David and Goliath situation that discourages investment, as opposed to encouraging it.”

While the university protects its employees, co-inventors are sometimes undergraduate students who are not protected and would have to pay for the damages. As a result, she said, they may be discouraged from filing patents — and, consequently, inhibited from advancing “innovation.”

Gary Falle, UC’s associate vice president for federal government relations, argues Congress needs to take a more “balanced approach” when addressing patent abuses.

“The UC is the lead in the nation in the number of patents (awarded annually), and we want to make sure that is protected,” said Falle. “We just want to make sure that the patents the university is awarded are able to move into technology, commercialization and innovation.”

Trimming the troll

Yet Robin Feldman, a law professor at UC Hastings College of the Law who researches patent trolling issues extensively, believes the legislation is vital to the abused patent system.

Feldman suggested universities might have underlying incentives in opposing the legislation. She noted that universities, while not filing patent lawsuits directly, may deliberately ally with nonpracticing entities to increase revenue.

“They do appear to be feeding the patent trolls at least to some extent,” she said. “There’s so much pressure on universities to find funding sources, and it is difficult for them to resist the temptation to sell to those who won’t make any products.”

Still, according to Mimura, UC Berkeley only licenses patents to commercial entities in accordance with university patent policy. And, despite what history may suggest, Mimura said the University of California does indeed support patent reform and has even reached out to Sen. Dianne Feinstein thanking her for support of patent reform.

In regard to current legislation efforts, the UC system only wants to shift the discussion in the right direction, Falle said.

“We believe that addressing bad behavior by stopping those who send multiple demand letters in the hope of extracting fees out of fear will be the focus of reform — not shutting down the entire patent system that is the goose that laid the golden egg,” Mimura said.

PRIVATIZATION OF PUBLIC HEALTH IS DRIVEN BY THE US AND IT IS ALL WRITTEN INTO THESE TRANS PACIFIC TRADE PACTS. THIS PACT WAS INITIATED BY BUSH AND CLINTON AND NOW OBAMA AND THE CLINTONS ARE OVERSEAS WITH US NEO-LIBERALS TRYING TO FORCE NATIONS ALL OVER THE WORLD TO SIGN A PACT THAT IS REALLY, REALLY, REALLY BAD FOR ALL CITIZENS INVOLVED.  WE HAVE A DEMOCRATIC PARTY CONTROLLED BY NEO-LIBERALS AND SO DOES MARYLAND.  ALL THE CANDIDATES FOR GOVERNOR OF MARYLAND WILL EMBRACE TRANS PACIFIC TRADE PACT AND THE DISMANTLING OF THE PUBLIC SECTOR IS PART OF THIS.

For those that believe the hype about bringing jobs, remember what NAFTA did----it decimated our economy and TPP be worse!

The You Tube video below shows a good view of the concerns for public health in the US.  You can see that Affordable Care Act is an extension of what this TPP requires of all nations.  I will take this week to look at all public sectors to see what TPP will do to our rights as citizens and how it moves the US from second world now to third world after TPP is installed.  Keep in mind that protests like this are happening all over the world and in the US but in Maryland------

NO ONE KNOWS WHAT IS HAPPENING BECAUSE THE MEDIA AND POLITICIANS ARE ALL CAPTURED AND WORKING FOR GLOBAL CORPORATIONS.


TPP protests hit Utah
www.youtube.com

Published on Nov 19, 2013

The lead negotiators for 12 countries involved in the Trans-Pacific Partnership began meeting today in Salt Lake City, Utah. The TPP is a potential new trade deal that would open up markets among nations along the Pacific Rim. The negotiations have largely been secretive so far, but the agreement is expected to impact jobs, the environment, consumer safety and more. Last week, transparency organization WikiLeaks published leaked chapters of the TPP covering intellectual patents, and the organization's co-founder, Julian Assange, slammed the deal. Ameera David speaks with RT's Ramon Galindo, who is in Salt Lake City and attended demonstrations today against the TPP agreement.


This video is from 6 months ago.....Obama is traveling overseas to firm up this deal. If you think all of this buzz is hyperbole you need to learn about what TPP does. It sets US law in a way that gives corporations all the power of profit in all nations involved and the laws written and signed into affect by this treaty can only be changed by a global corporate tribunal.

IT ENDS OUR STATUS AS CITIZEN, OUR EQUAL PROTECTION UNDER LAW, OUR BILL OF RIGHTS AND THIS IS WHY WE ARE SEEING OUR WEALTH STOLEN, OUR CIVIL LIBERTIES AND RIGHTS OPENLY ABUSED....TPP IS ILLEGAL AND A COUP AGAINST THE US CONSTITUTION AS IT ASSAULTS OUR RIGHTS AS CITIZENS.

If your pol is not shouting this-----they are neo-liberals who intend on embracing TPP. Cindy Walsh for Governor of Maryland is the only candidate in the race that will use the governor's office to fight back and stop the TPP structures already being built in Maryland. We must return to a domestic economy. CONGRESS AND STATE AND LOCAL GOVERNMENT KNOW WHAT IS HAPPENING....THIS IS WHY THEY ARE PRIVATIZING ALL THAT IS PUBLIC GIVING GLOBAL CORPORATIONS COMPLETE CONTROL IN OUR STATE AND CITY.

It's important to think about the fact that all of these TPP negotiations have taken place during all of Obama's terms in office and Congress knew these terms on health care because I KNEW THESE TERMS ON HEALTH CARE.....I AM JUST AN AVERAGE CITIZEN THAT DOES RESEARCH.  DO NOT LISTEN TO YOUR POLS AT STATE AND NATIONAL LEVELS TELL YOU THEY WERE IN THE DARK.


TPP would make health care even more expensive, less accountable, less accessible

June 21, 2013 Green Party

Health Council of the General Welfare Branch

The Trans-Pacific Partnership (TPP) is a deal that is being secretly negotiated by the White House, with help from more than 600 corporate advisors, and Pacific Rim nations including Vietnam, Malaysia, Singapore, Brunei, Chile, Peru, Australia and New Zealand. While the TPP is being called a trade agreement, the United States already has trade agreements covering 90 percent of the GDP of the countries involved in the talks. Instead, the TPP is a major power grab by large corporations.

The text of the TPP includes 29 chapters, only five of which concern trade. The remaining chapters are focused on changes that multinational corporations have not been able to pass in Congress such as restrictions on internet privacy, increased patent protections, greater access to litigation and further financial deregulation.

So far, all that is known about the contents of the TPP is from documents that have been leaked and reports from non-governmental organizations and industry meetings. Unlike other trade deals, the White House refuses to make the text available to the public. In fact, the negotiators refuse to publish the text until four years after it is signed into law.

From the information available, one thing is clear about the impacts of the TPP on health care. The intention of the TPP is to enhance and protect the profits of medical and pharmaceutical corporations without regard for the harmful effects their policies will have on human health.

We know that the TPP will extend pharmaceutical and medical device patents and provide other tools to keep the prices of these necessities high. This will make medications and treatments unaffordable for millions of people and raise the costs of national health programs, including public health systems in the U.S.. At its worst, the TPP will provide a pathway to infect the world’s health systems with the deadly parasite of for-profit health corporations that plague the United States.

The major health threats posed by the TPP include:

• Extensive patent protections. Through the TPP, pharmaceutical and medical device corporations are seeking extensive patent protections using a process known as ‘Evergreening.’ The TPP gives twenty years of patent protection for pharmaceuticals and medical devices; however, patents can be renewed for another twenty years each time there is a change in an indication or delivery. 
  • Doctors without Borders criticized this practice, stating that patent protections in previous trade agreements raised the price of life-saving medications and made them unavailable to people in poorer countries. Patents prevent the production of low cost generic forms of medications. 
  • Because of the negative impact on public health from patent protections in previous trade agreements, such as the Korea Free Trade Agreement, former President Bush rolled some of these practices back. Unfortunately, the TPP will move them forward again. In fact, the TPP goes farther to require patents on surgical techniques, medical tests and treatments.
• Prevention of necessary innovation. Doctors without Borders also expressed concern that patent protections encourage innovation based on profit instead of on the needs of people, particularly those in poor nations. Corporations do not see it as in their financial interest to address health conditions more prevalent in poor nations which do not have the financial resources to buy their products. But it is often in these situations where treatment can have the greatest impact on quality of life.
• Attack on public health systems. An area of great concern is language within the TPP concerning State-Owned Enterprises (SOEs). These are institutions that are fully or partially owned by governments, which could include public health systems.
  • Corporate lobbyists are concerned that SOEs have ‘unfair advantages’ over private industry. These advantages include government subsidies, preferred tax status, low finance rates and access to capital. According to a leaked chapter, corporate lobbyists believe that there is a conflict of interest because SOEs have political considerations such as functioning to provide basic goods and services for their population and believe that instead SOEs should operate strictly as commercial entities.
  • The TPP requires SOEs to disclose any special advantages they receive and the government to give the same advantages to corporations. It also provides methods for corporations to sue governments if they believe that they are not being treated fairly.
  • Text from a section of the TPP called “Annex on Transparency and Procedural Fairness for Healthcare Technologies” was leaked in June, 2011. It reveals that medical industries are pushing on all fronts to keep their prices and prevent public health systems from negotiating to keep prices affordable. To medical industries, price negotiation is one of the ‘unfair advantages’ of public health systems. When a public health system negotiates a lower price, it is said to be exerting its market power. On the flip side, when a government extends patent protections to medical industries, this is not considered to be a use of market power by the industry.
• Greater control over reimbursement. Medical industries are pushing for other concessions within the TPP to ‘level the playing field,” also known as forcing public entities to operate as market-based entities, such as factoring the cost of not just research, development and production of drugs and medical devices but also the cost of marketing them into what is considered to be a fair market price. And they only view prices negotiated without any government influence as fair. These provisions are significant because the TPP allows pharmaceutical corporations and others to challenge the legitimacy of any reimbursement decisions made by public health systems through the courts.
  • Patent and price protections for multinational pharmaceutical and medical device corporations based in the U.S. will benefit their bottom line and their investor’s pockets, but may bounce back and undermine public health systems in the U.S.. The leaked text indicates that the above provisions only apply to health authorities under the jurisdiction of the federal government. However, the loop holes are large enough that all of the U.S. public health systems, which include Medicare, Medicaid, Tricare and the Veterans Health Administration, can arguably be considered to be federal.

To solve the health crisis in the U.S., we must move away from privatization of health care and towards a public health system with a mission to improve and protect the health of the public.

Therefore, the Health Council of the Green Shadow Cabinet opposes provisions within the TransPacific Partnership that make profit more important than public health. We oppose all provisions that restrict access to necessary medications, medical tests and treatments. Rather than the expansion of patent protections, there should be increased sharing of medical knowledge to promote improved global public health.

~ The Health Council is led by Secretary of Health Dr. Margaret Flowers, serving within the General Welfare Branch of the Green Shadow Cabinet.  This statement is one of over a dozen issued in support of the Green Shadow Cabinet's June 17th call for action against the TPP.

____________________________________________

Let's look locally to see how TPP drives Maryland health care reform.  Maryland is the only state in the nation that seeks exemption from Medicare and is given it.  This means that there is no Federal oversight or requirements that have to be met.  This is why Medicare is handled in Maryland as all health care----it is tiered rather than universal as the Federal program requires.  Maryland has spent these two terms under O'Malley dismantling public health and building private non-profit and corporate structures to handle public sector health care and it is building what is a clinic system for the lower/middle class that is modeled on third world clinic care.  Mind you, the working class and middle class that were driven into poverty from this massive fraud and now the capture of our economy with deliberate high unemployment has moved over 70% and rising of US citizens into or near poverty and they plan to keep pushing more into poverty.  So, this clinic care overage that is mostly preventative care will pertain to almost all US citizens.  Remember, public and private health plans are going to be sent to these state health systems as are Medicare and Medicaid and you will only received the amount of care your income category places you.  Medicare gives equal levels of care to all citizens because people pay their whole lives into Social Security and Medicare. 

TO PROTECT AGAINST THIS DISMANTLING OF OUR FEDERAL HEALTH PROGRAMS WE MUST MOVE FROM THIS PRIVATE HEALTH CARE SYSTEM TO EXPANDED AND IMPROVED MEDICARE FOR ALL.  OTHER STATES HAVE ALREADY MOVED THIS WAY AND MARYLAND NEEDS TO AS WELL.

No matter how much they tell you all of this clinic care is going to make things easier and offer more access-----THEY ARE LYING.


The TPP’s Threats
to Public Health


The Trans-Pacific Partnership (TPP) is an international trade and investment pact currently under
negotiation between the United States, Australia, Brunei Darussalam, Canada, Chile, Malaysia, Mexico,
New Zealand, Peru, Singapore and Vietnam. It is also specifically intended as a “docking agreement”
that other countries would join over time, with Japan, Korea, China and others already expressing some
interest. U.S. negotiators are pushing to complete the TPP as soon as possible.
NEGOTIATIONS ARE HEADED IN THE WRONG DIRECTION ON PUBLIC HEALTH

A roll back from the Bush administration. Leaked U.S. proposals for several chapters in the Trans-
Pacific Partnership reveal that U.S. trade negotiators have reversed hard-won reforms designed to
enhance access to affordable medicines that were made during the George W. Bush administration. In
addition to pushing for increased monopoly rights for drug companies, the U.S. is also demanding new
rights for pharmaceutical firms to challenge pricing and other drug formulary policies used by many
countries to keep down health care costs.
PACT WOULD REDUCE ACCESS TO GENERIC MEDICATION BY EXTENDING DRUG PATENTS
Access to generic medicine is critical to saving lives. The first generation of HIV drugs has come
down in price from roughly $10,000 per patient per year to just $120 thanks to increased access to
generic medications. This reduction in price has helped to dramatically scale up the number of people
throughout the world who are now receiving treatment. The Global Fund to Fight AIDS, Tuberculosis
and Malaria, the President’s Emergency Plan for AIDS Relief, UNITAID and UNICEF all rely heavily on
access to quality generic medications. For millions of people throughout the globe, delaying access to
generic medications means delaying access to treatment.
The U.S. proposal would grant new monopoly patent rights, reducing access to generic
medicine. If finalized and implemented, the leaked U.S. intellectual property proposal would roll back
access to generic medicine for people in
developing countries and throughout the
world. Specifically, the U.S. proposal would
broaden the scope of patentability by making
it easier for pharmaceutical companies to
patent new uses and minor variations of old
medicines; slow the production of new
generics when patents expire by expanding
“data exclusivity” over clinical trials forcing
either the timely and costly replication of such
trials or an additional three-year delay
(beyond the current five) before such
“exclusivity” ends; constrict safeguards
against patent abuse by making it harder for
public health advocates to challenge
unjustified new patents; require new forms of
drug patent policing; and mandate that
countries allow patents on plants, animals
Trade Policy & Access to Medicine
and surgical methods. The U.S. is expected to also request extensions beyond existing 20-year drug
patents to “compensate” drug companies for time spent in regulatory approval processes.
International public health advocates are speaking out. According to Doctors Without
Borders/Medecins San Frontieres: “Access to affordable lifesaving medicines will be threatened where
they are needed most — in parts of the developing world — if the U.S. insists on implementing
restrictive intellectual property policies in the Trans-Pacific Partnership trade agreement... The leaked
USTR position paper, now available to the public, reveals that the U.S. is pushing its trade partners,
including developing countries, to effectively lower the bar for granting patents, limit the capacity to
challenge patents, and impose new forms of intellectual property enforcement — all measures that
delay the introduction of more affordable generic drugs.”
EMPOWERING DRUG COMPANIES TO ATTACK COST-SAVING DRUG FORMULARIES
Governments use cost-saving drug formularies keep drug prices in check. Governments use
formularies to control health costs by listing medicines approved for government purchase or
reimbursement, and negotiating with drug firms to obtain the lowest prices. Among the current TPP
countries, such formularies are most associated with New Zealand’s Pharmaceutical Management
Agency (PHARMAC) and Australia’s Pharmaceutical Benefits Scheme (PBS), but they are also used by
other governments, including a number of federal and state-based programs in the United States.
The U.S. proposal seeks to restrict cost-saving drug formularies. The leaked U.S. proposal for a pharmaceutical pricing chapter restricts the use of such formularies, by requiring that countries set up
new administrative and judicial appeal systems to help determine whether government programs
“appropriately recognize the value” of drug patents in their reimbursement proposals. In Australia, the only country yet to implement such systems under a trade agreement, the result has been higher drug
prices.


NEGOTIATIONS HAVE BEEN TAKING PLACE IN THE
SHADOWS

The Trans-Pacific Partnership negotiations have not
been transparent. Access to medicine has received the
attention it has because the U.S. proposals for
intellectual property and pharmaceutical pricing chapters
for the pact have been leaked. Neither of these, nor any
other negotiating texts, has been officially released. This
is completely undemocratic, and also outside the norm
for many international negotiations, including those at the
World Trade Organization, where draft negotiating texts
are regularly published. This excessive secrecy makes it
extremely difficult for civil society to comment on the
negotiations in a productive way while the pact is still
under negotiation and such comments could be valuable.



Learn more & get involved: www.citizenstrade.org

_________________________________________

The Affordable Care Act specifically states that Medicare PHARMA will now be generic in many cases and as we read above TPP seeks to greatly limit generics.  So, if policy pushes seniors towards using generics at the same time policy works to protect Brand names from generics-----

YOU SEE WHERE THIS WILL LEAD.  MOST PEOPLE WILL NOT BE ABLE TO AFFORD NAME BRAND AND THE NUMBER OF GENERICS WILL BE VERY LIMITED AND RESTRICTED TO THE OLDEST OF FORMULAS.

Below you see what ACA promises as all over the world we know the opposite is planned with TPP.  I have a friend already affectived negatively by having to leave a brand name drug for a generic that does not work as well.  This will be wide-spread and people will die from simple lack of access to common drugs.

SELLING THE AFFORDABLE CARE ACT

 Thousands in Savings by Providing Discounts in the Medicare “Donut Hole”
o More than 8 million seniors in 2007 hit the “donut hole,” or gap in prescription drug coverage in Medicare Part D. The Patient Protection and Affordable Care Act will provide low and middle-income seniors a 50 percent discount on brand-name drug and biologic prices in the donut hole. It will also shrink the gap by $500 per senior for 2010.
 More Affordable Generic Drugs
o Some cutting edge drugs are simply too expensive for many seniors. The Patient Protection and Affordable Care Act will create a pathway for the approval of generic biologic drugs to improve affordability of medications for seniors and all Americans.

Better preventative care for seniors and the poor!  Well, if all these groups will be able to access is preventative care -----will this be better?

OF COURSE NOT----THEY ARE SIMPLY BUILDING A STRUCTURE THAT A SUPER-MAJORITY OF AMERICANS WILL BE PUSHED TO.

Aren't neo-liberals just great allowing the American people the chance to buy yet another health insurance policy directed at long-term care?  The Social Security Disability program is being allowed to be gutted and emptied through fraud in the trillions of dollars and it will end.  Where will all those people with disabilities go?  Well, if you cannot afford yet another insurance policy you will see longevity fall steeply in America in just one generation.

IT TAKES A SPECIAL KING OF PERSON TO PUSH THIS AS POLICY ALL BECAUSE MEDICARE AND MEDICAID WAS GUTTED WITH FRAUD AND PROFITEERING AND NOW THESE HEALTH INSTITUTIONS NEED MORE PROFITS.

In Maryland the driver of these policies and in fact the institution writing these policies is Johns Hopkins University.  Mind you, they have made themselves a global health system through these massive frauds.

Preventive Care for Better Health
o Today, seniors must pay 20 percent of the cost of many preventive services. The Patient Protection and Affordable Care Act will eliminate deductibles, copayments, and other cost-sharing for preventive care, and provide free annual wellness check-ups.

 Affordable Long-Term Care

o Sixty-five percent of seniors need long-term services at home, at an average cost of $18,000 each year. The Patient Protection and Affordable Care Act will create a voluntary long-term care insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.


_______________________________________________
The idea of the Affordable Care Act is to deregulate and dismantle all the public oversight of health care so that the industry can act with impunity just as banks do.  So, health care once controlled within the confines of medical professionals are now handed to private corporations acting as clinic care and of course this will be the only access for the middle-working class families not able to afford the Silver or  higher health plans.

That goal of deregulation takes the form of placing health care everywhere-----at the same time public justice and oversight and accountability is dismantled meaning the public never knows if care is happening or where the money went. I further devolves the US into this third world systemic fraud and corruption this time with our health care.  People will die because tons of money is misappropriated and stolen and people will not have equal access rights as people will be denied for any reason.  THAT'S WHAT LOSING EQUAL PROTECTION IS ALL ABOUT!

When you read that 30 million people will be entering the system it is mostly the people mandated to buy insurance with no protections on how high those insurance rates will go----and they will go high.

MANDATED TO BUY INSURANCE THAT ONLY ALLOWS YOU ACCESS TO PREVENTATIVE CARE AND THEN THOSE RATES CAN SOAR.....

PEOPLE WILL BE BANKRUPTED IN NO TIME AND LIVE IN POVERTY IF THEY TRY TO ACCESS ORDINARY MEDICAL PROCEDURES.

The Affordable Care Act Will Drive Retail Pharmacies To Higher Profits

Nov. 14, 2013 6:23 PM ET  |  Includes: ABC, CVS, ESRX, RAD, WAG Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. (More...)

It's been a good year for the three major retail pharmacy chains: YTD CVS Caremark (CVS) is up 31%, Walgreen Co. (WAG) is up 61%, and Rite Aid (RAD) has soared 286%. With more generic drugs coming to market and the Affordable Care Act (ACA) less than two months away, retail pharmacy chains are gearing up to welcome what is expected to be an onslaught of newly insured Americans. With the changes in healthcare, pharmacy chains are expanding their reach to become a one-stop healthcare shop for not just prescriptions, but for other medical needs such as flu shots and minor injuries. Soon these retail pharmacies will further encroach on an area where physicians once had the monopoly: managing chronic diseases such as diabetes and asthma. This strategy should add to more revenue for the pharmacy chains with both CVS and Walgreen leading the way.

Adam J. Fein, a healthcare industry consultant who runs the Drug Channels blog, sees changes coming to the way people are currently treated. "Retail competition is coming to healthcare, and pharmacies are on the leading edge." According to the Congressional Budget Office, healthcare spending in America will balloon to 22% of gross domestic product in 2038, from 16.4% in 2011. That means that healthcare spending will account for more than a fifth of the economy, and retail pharmacies are looking for a larger piece of the pie as they move beyond filling prescriptions.

ACA -- Making Pharmacies A One Stop Shop

The government's ACA will bring in approximately 30 million newly insured customers into the healthcare system. Walgreen, CVS, and Rite aid recognize that the millions of people who stand to gain health insurance represent an opportunity for increased pharmacy business in all aspects of the store from drugs to personal products to acute medical needs. To insure a share of the new found customer base, the pharmacy companies have been working closely with the government in promoting uninsured customers to sign up for health insurance with the goal of having them visit the pharmacy clinic and load their baskets with front end merchandise.

____________________________________________
Raise your hand if you understand that policy with a goal of consolidating and deregulating the health industry combined with mandated purchase of insurance would lead to insurance industry capture of the American people!  EVERYONE

THESE POLS ARE NOT FIGHTING IT----THEY VOTED THE AFFORDABLE CARE ACT INTO PLACE KNOWING THAT THIS WOULD HAPPEN.

It is just as when neo-liberals with Clinton broke the Glass Steagall wall and passed NAFTA killing the middle-class and creating unaccountable global corporations. 

THE SAME POLS IN OFFICE NOW DID THAT THEN AND WE KEEP VOTING THEM BACK INTO OFFICE!

In Maryland that is Cardin, Sarbanes, Cummings, Hoyer still in office from moving the US from first world to second world and now working to send the US to third world.


Remember, the Trans Pacific Trade Pact specifically states that any national law that interferes with corporate profit will be ignored by global corporations.  So, any law passed that supposedly controls cost will not legally stand when TPP is passed.  A deregulated insurance industry will soak Americans for all they are worth.



'Powerful corporate interests want to use the TPP to:


- Offshore good-paying jobs to low-wage nations and undercut working conditions globally and further reducing wages in the United States

- Create new tools for attacking environmental, health, labor and consumer safety standards

- Expand the deregulation of banks, hedge funds and insurance companies

- Further concentrate global food supplies, displacing family farmers and subjecting consumers to wild price fluctuations

- Institute longer patents that restrict access to affordable, generic medications'


Health Insurance Premiums Are Soaring as Industry Profits Continue to Rise - Sen. Feinstein, Rep. Schakowsky, Maine Insurance Superintendent and State Insurance Experts Say Regulation Works to Hold Down Rate Increases

Wednesday, May 11, 2011 General News  MED INDIA

Who: Sen. Dianne Feinstein

Rep. Jan Schakowsky

Mila Kofman - Maine Insurance Superintendent

Harvey Rosenfield and Carmen Balber - Consumer Watchdog

What: Newsmaker Briefing: "How Health Insurance Rate Regulation Can Lower Premiums and Save Health Reform"

When: 2:00 p.m. - 3:30 p.m., Wednesday, May 11.

Sen. Feinstein and Rep. Schakowsky will open the briefing

Where: 116 Dirksen Senate Office Building

Constitution Ave and 1st St NE, Washington, D.C.

Join Sen. Feinstein and Rep. Schakowsky, Maine's top insurance regulator and state insurance experts to discuss spiraling health insurance rate increases and how regulation can hold down costs for consumers at a Consumer Watchdog briefing Wednesday afternoon on Capitol Hill.

Consumer Watchdog will also release a new report that examines health insurance rate regulation in the states, and finds that states that are instituting or strengthening laws requiring rate review and approval, including New York, Massachusetts and Maine, are seeing cost-control results.

Sen. Feinstein and Rep. Schakowsky introduced legislation in the 112th Congress to require HHS or the states to reject excessive or unjustified health insurance rates.

Maine Insurance Superintendent Mila Kofman has used that state's law to conduct comprehensive reviews of rate increases -- including public hearings, consumer intervenors and transparency requirements -- to protect consumers from millions in unnecessary rate increases.

Consumer Watchdog founder Harvey Rosenfield wrote California's model law for review and prior approval of property casualty insurance rates that has saved drivers $62 billion.

Consumer Watchdog Washington, DDCD director Carmen Balber will outline HHS regulations from the federal health reform law requiring review of unreasonable rate increases, and highlight regulatory successes and failures in other states.

Health insurance premiums increased 138% in the last decade while medical inflation rose just 31%. 1st quarter 2011 financial reports show health insurance industry profits are on track to beat last year's huge results. Consumer Watchdog's report finds that, if premium increases continue unchecked, health reform will fail in its primary goal of expanding access to health insurance.

CONTACT: Carmen Balber, +1-202-629-3043, cell: +1-310-403-0284, Judy Dugan, cell +1-213-280-0175

/PRNewswire-USNewswire -- May 10, 2011/

SOURCE Consumer Watchdog

ALL CANDIDATES FOR GOVERNOR OF MARYLAND INTEND TO CONTINUE THIS MOST PRIVATE AND PROFIT-DRIVEN OF STATE HEALTH SYSTEMS IN THE NATION  EXCEPT CINDY WALSH FOR GOVERNOR.  WHERE DO NEO-LIBERALS IN MARYLAND GO WHEN YET ANOTHER PRIVATE CONTRACTOR IS GIVEN HUNDREDS OF MILLIONS TO FAIL?  GLOBAL CORPORATE NEO-LIBERALS GO TO THE CONNECTICUT MODEL-----CONNECTICUT BEING WEALTH AND PROFIT AND HOME OF THE US INSURANCE INDUSTRY.

YOU WILL NOT HEAR A CORPORATE NEO-LIBERAL TALK ABOUT EXPANDED AND IMPROVED MEDICARE FOR ALL OR GIVE YOU A HEADS UP THAT THESE PRIVATE SYSTEMS ARE GEARED TO ENDING MEDICARE AND MEDICAID.

Today I would like to look at what happens when oversight and accountability is taken from health care and when patients become a vehicle to profit rather than a consumer of public health.  We know that PHARMA now manufactures drugs with an eye on how to increase profit----so, we have drug shortages for drugs vital to people but not profitable for drug corporations to make.  Patent extensions are being built and we know Trans Pacific Trade Pact specifically makes it harder for generic drugs to hit the market at a time when the Affordable Care Act specifically states the American people will use generic over name brand.  We know that fraud and corruption is systemic in the health industry taking 1/2 of health spending. 

ALL THIS HAPPENS BECAUSE OF DEREGULATING AND PRIVATIZING PUBLIC HEALTH.


I watched FOX NEWS a few weeks ago and it had as a report that OLESTRA was actually good for you.  Remember, olestra is the food additive that made everyone sick and it was found to be harmful to health and foods having it were pulled from the market a decade ago.  Well, its back and now they are marketing that olestra is good for you, neutralizing all kinds of bad environmental stuff in foods.  The report was given by a man with no public health background----he appeared to simply be a corporate researcher.  THIS IS FOX NEWS MARKETING A FOOD KNOWN TO BE HARMFUL TO AN AUDIENCE LARGELY WORKING CLASS AND POOR.....


We are seeing more and more where the Federal agencies charged with public health are silent on all matters regarding the efficacy ------whether things are helpful or harmful-----and allow corporations to market as they want regardless of clinical trial.  The American people are now exposed to deliberate health harm.  THIS IS WHAT HAPPENS WHEN PUBLIC HEALTH IS DISMANTLED.  Maryland has no oversight or accountability and Maryland Assembly has passed laws making it as hard as possible for Maryland citizens to seek justice in cases of medical misconduct.

That's what corporate neo-liberals do-----stop voting for them in primaries----run and vote for labor and justice.

Center for Science in the Public Interest

The Problems With Olestra
Olestra rapidly depletes blood levels of many valuable fat-soluble substances, including carotenoids. Olestra has an extraordinary avidity for certain fat-soluble substances, far exceeding what one would expect based on the fat substitute's proportion of the diet. Olestra's removal from the body of fat-soluble nutrients is linked directly to the additive's being a non-absorbable lipid-like substance.

In Procter & Gamble's two eight-week clinical studies, the lowest level tested -- 8 gm/day (equivalent to 16 olestra-containing potato chips) — caused dramatic depletion of fat-soluble vitamins within two weeks. Procter & Gamble also measured total serum carotenoids, alpha-carotene, beta-carotene, lutein, and lycopene. Olestra caused significant declines in all carotenoids monitored. Total serum carotenoids declined sharply by the fourteenth day of olestra consumption and was down by 50% to 60% by the end of the studies. A dosage of 32 gm/day of olestra reduced total serum carotenoids by 70% over the eight weeks.

In a recent four-week study conducted in Holland, 3 gm/day (equivalent to just 6 potato chips) of sucrose polyester (the general name for olestra-like chemicals) caused a 20% decline in beta-carotene levels and a 38% decrease in lycopene, another key carotenoid (Am. J. Clin. Nutr. 62:591 (1995)).

Feeding olestra with one or more meals, as was done in the several clinical studies, results in the greatest depletion of carotenoids. While that might seem to be a worst-case scenario, many people would, indeed, consume olestra-containing foods with meals. In fact, Procter & Gamble's petition states that mealtimes constitute the great majority (79%) of the occasions during which consumers eat "savory snacks." Also, since the frequency of consumption of snacks would likely increase if olestra snacks were available, interaction between nourishing foods and olestra at meals would be likely to increase, resulting in lower serum levels of fat-soluble carotenoids and other phytochemicals. There would also be more opportunities for olestra to reduce the absorption of beta-carotene and fat-soluble vitamins that people ingest in dietary supplements and fortified foods.

Olestra's depletion of carotenoids is of great concern, because a growing body of evidence indicates that they may confer important health benefits. The physiological activities of fat-soluble plant nutrients are just now being elucidated. For instance, in a recent case-control study, lutein (along with zeaxanthin) was strongly associated with a lower risk of macular degeneration, the most common cause of blindness in the elderly (J.A.M.A. 272: 1413 (1994)). That observation is buttressed by the fact that lutein and zeaxanthin form the yellow pigment in the macula (the central part of the retina). In three clinical studies, 3 gm/day of sucrose polyester or 8 gm/day of olestra reduced lutein levels by 20% to 40%.

Cancer experts are urging Americans to eat much greater quantities of vegetables and fruits, in part because of their carotenoids and other phytochemicals. Beta-carotene and other carotenoids have reduced cancer incidence in animals exposed to carcinogens. (J. Nutr. 119:123-6 (1989); Am. J. Clin. Nutr. 53(1 Suppl):238#-246S (1991))

In humans, numerous epidemiological studies have linked diets rich in carotenoid-rich fruits and vegetables to lower risks of cancers of the lung, esophagus, pharynx, mouth, stomach, colon, rectum, and bladder. Several studies have found an association between low levels of serum beta-carotene [which could be a marker for other carotenoids) and high rates of stomach and lung cancer. (Am. J. Epidemiol. 135: 115 (1992)]

The Surgeon General's Report on Nutrition and Health, released in 1988 by the Department of Health and Human Services, states:

[E]pidemiological studies provide suggestive evidence that consumption of foods containing carotenoids, including the beta-carotene precursor of vitamin A, protects against development of epithelial cell cancers such as those of the oral cavity, bladder, or lung. These studies have generally shown lower rates of cancer among individuals consuming the highest overall levels of vitamin A, carotenoids, or fruits and vegetables. The National Research Council stated in its landmark 1989 report, Diet and Health, "[T]here is strong evidence that a low intake of carotenoids, which are present in green and yellow vegetables, contributes to an increased risk of lung cancer." The director of the National Cancer Institute's "5 A Day" program pointed out the plausible biochemical mechanisms for the association between fruits and vegetables and lower cancer risks:

Fruits and vegetables are sources of vitamins and minerals (including vitamins A, C, E, and folate), carotenoids and other antioxidants, fiber, and various phytochemicals. . . . Each of these substances may play a role in reducing risk. More likely, it is a combination of these factors, and others not yet explored, which may confer protections. (J. Heimendinger, program director, The National 5 A Day for Better Health Program, Scientific and Program Design Rationale (Aug. 10, 1994) In January, 1996, just three weeks before the FDA approved olestra, the federal government (HHS, USDA) published the newest edition of Dietary Guidelines for Americans, the nation's basic nutrition policies. That document urged people to consume carotenoid-rich fruits and vegetables because of their likely role in preventing cancer and other chronic diseases.

While there is not yet conclusive proof that carotenoids reduce cancer risk, to approve a major new additive that would significantly reduce levels of carotenoids (and possibly other fat-soluble phytochemicals) defies logic. It is a remarkable case of governmental ineptitude to have one agency of the Department of Health and Human Services, the National Cancer Institute, encouraging consumers to eat more carotenoid-rich fruits and vegetables, while another agency, the FDA, approves a food additive that depletes the body of potentially beneficial substances in those foods.

Supplementing olestra with selected vitamins will not solve all of olestra's nutrient-depletion problems. Olestra is highly effective at reducing serum levels of the fat-soluble vitamins A, D, E, and K. Simply supplementing olestra with those vitamins, as Procter & Gamble has proposed, would not completely solve that problem. Consider the 1.5 million patients taking the anticoagulant drug Coumadin (warfarin). Coumadin therapy often employs low doses of the anticoagulant, making the drug's efficacy particularly sensitive to fluctuations in vitamin K levels. Eating snack foods containing olestra and added vitamin K might cause substantial fluctuations in serum vitamin K levels, possibly impairing the efficacy of Coumadin. Furthermore, researchers are now identifying important functions for vitamin K other than those associated with blood clotting, such as bone formation in fetal development and childhood and retention of bone in older women.

No animal or clinical studies have demonstrated that vitamin K-supplemented olestra would be safe for Coumadin users and effective in maintaining physiological functions in addition to blood coagulation.

Doctors will have to warn their patients to avoid olestra (or, more safely, all snack foods of unknown composition).

Olestra causes gastrointestinal disturbances, which are sometimes severe, including diarrhea, fecal urgency, and more frequent and looser bowel movements. A variety of gastrointestinal symptoms occurred in subjects who consumed on a daily basis the amount of olestra that would be found in less than one ounce of potato chips (about 16 chips), as well as higher doses. For instance:

• In Procter & Gamble's eight-week vitamin-restoration study, 8 gm/day of olestra caused a five-fold increase (1/17 versus 5/17) in diarrhea compared to the incidence in controls who ate natural fat.

• In the eight-week vitamin-restoration and dose-response studies, 32 gm/day (the amount in about 3 ounces of chips) caused diarrhea in half the subjects (9/17 in one study, 13/24 in the other); control groups had much lower incidences (4/21 and 1/17, respectively).

• In the dose-response study, 8 gm/day of olestra increased the total number of incidents of gastrointestinal symptoms — including diarrhea, loose stools, nausea, gas, and others — from 40 to 66 (65% increase). In the two clinical studies, 20 gm/day of olestra caused roughly a doubling of the number of incidents compared to controls.

• At all doses of olestra in both eight-week studies, one or more people experienced symptoms that persisted on an intermittent basis for at least 40 days.

Gastrointestinal disturbances are not normally life-threatening, but they can be very inconvenient, unpleasant, uncomfortable, and worrisome. Imagine the plight of a school child who must repeatedly request permission to go to the toilet (and consider the teacher's plight, too). Think of the driver of a giant 18-wheeler barreling down the highway at 70 miles per hour when he gets hit with a bout of fecal urgency. Consider a teenager on a first date when he or she is constantly worrying about diarrhea and gas. Or a young woman who has to see a doctor because she worries that her nausea might be caused by a pregnancy, or an elderly person who fears that his diarrhea reflects a serious intestinal problem. Many people will eventually link the olestra snack foods to their gastrointestinal problems, but they may experience much discomfort before they make that link. And as long as olestra snack foods are marketed, new consumers will constantly be experiencing those problems.

Olestra sometimes causes underwear staining associated with "anal leakage." Olestra sometimes causes underwear staining. That phenomenon may be caused most commonly by greasy, hard-to-wipe-off fecal matter, but occasionally also from anal leakage (leakage of liquid olestra through the anal sphincter).

Procter & Gamble conducted a study that examined the effects of different formulations of olestra. The study used a dose of 34 gm/day, but, unfortunately, it lasted only five days, so it must be considered very preliminary. However, even that study showed that anal leakage occurred at a slightly higher rate in the test groups consuming the types of olestras than in the control group (which, inexplicably, included 2 cases of anal leakage). In addition, anal leakage was reported by one subject in the high-dose group (32 gm/day) of the eight-week dose-response study. Given the small size of the study groups (an average of 20 subjects/group) in the two eight-week studies, this single occurrence adds further evidence that Procter & Gamble has not yet resolved the anal leakage problem in heavy consumers of olestra.

Although underwear staining and anal leakage do not endanger consumers' physical health, those phenomena could cause psychological problems, including feelings of embarrassment and insecurity. Children and teenagers, especially, are likely to be disturbed about having dirty underwear, fearing embarrassment in front of friends and family. Snacking should be a pleasure undiluted with problems like dirty underwear.

Another condition associated with olestra consumption, "oil in toilet," occurred frequently in Procter & Gamble's two eight-week clinical studies. It could be disconcerting and might spur some people to see their doctor.

Data are lacking on the health effects of olestra on potentially vulnerable segments of the population. Key tests were unacceptably brief. Only poor studies have examined the effect of olestra on gastrointestinal disturbances in children, while no studies at all have focused on gastrointestinal problems and nutrient losses in healthy people over 44 years of age and people with poor nutritional status. For instance, the longest test on children, who would likely be major consumers of olestra-containing snacks, lasted only 7 days and exposed children to an average of only 7 gm/day of olestra, equivalent to two thirds of an ounce of potato chips. People who had poor diets and relatively low levels of carotenoids and who ate olestra regularly might be at special risk.

Furthermore, Procter & Gamble has not conducted human studies to assess the potential long-term health effects of olestra consumption. The results from brief (eight-week) clinical trials suggest possible serious long-term nutrient depletion and gastrointestinal effects for regular consumers of olestra. Eight-week-long studies are inadequate for a product that may be consumed by millions of people at high levels over a lifetime. Long-term tests on various population groups are essential to ascertaining the health effects of olestra. In addition, Procter & Gamble must conduct human studies to demonstrate the effect on serum carotenoid levels of occasional consumption of various amounts of olestra.

Olestra's possible carcinogenicity needs to be better resolved. Olestra was fed to rats (two studies) and mice (two studies) for two years at levels up to 10% of the animals' diets. Liver foci, which may be precursors of cancer, occurred in both rat studies. In one mouse study there was a statistically significant increase in lung tumors in the two highest-dosage groups; those tumors were not seen in a second study.

The levels of olestra fed to the rats and mice are of the same order of magnitude likely to be consumed by people. Especially since there is little margin of safety between human and animal consumption in these studies, findings of liver lesions in both rat studies and lung tumors in one mouse study are of particular concern. The FDA should appoint a committee of independent cancer experts (who do not consult for industry) to review the animal data and determine whether the liver foci and lung tumors (a) are definitely not a problem, (b) provide clear evidence of risk, or (c) raise questions that must be resolved through further research.

Procter & Gamble's claim that olestra's gastrointestinal effects are similar to those caused by high-fiber diets is not true. Procter & Gamble has claimed that olestra has gastrointestinal effects that are comparable to those caused by eating larger amounts of dietary fiber. In fact, the gut microflora usually adjust quickly to increased fiber, but do not adjust to olestra. Increasing fiber consumption often results in flatulence and similar effects, but, as the National Research Council has pointed out in Diet and Health, those effects seem to be temporary. Olestra's adverse effects persisted throughout the two eight-week studies and can be eliminated only by ceasing consumption of olestra.

It is not possible to set an Acceptable Daily Intake (ADI) for olestra use in snack foods. An ADI for food additives is normally set by dividing the highest "no-observed-effect level" (NOEL) by a safety factor. However, Procter & Gamble has not been able to demonstrate a NOEL for olestra. In eight-week clinical studies, important adverse effects, including depletion of fat-soluble carotenoids and vitamins and gastrointestinal disturbances, occurred at 8 gm/day, the lowest olestra consumption level tested. Arguendo, if 8 gm/day were considered the NOEL for olestra, dividing by a minimal safety factor of 10 would yield an ADI of 0.8 gm/day, far below the likely consumption levels for olestra if the pending petition were to be approved. If the 3 gm/day level of sucrose polyester at which other investigators found significant depletion of carotenoids were used as the NOEL, application of the 10-fold safety factor would result in a 0.3 gm/day ADI, even further below the likely daily intake of olestra from savory snacks.

The only NOEL justified to date for olestra is zero and that fact alone should have been sufficient to deny the petition. Of course, one could argue that diarrhea, fecal urgency, and flatulence are merely "unpleasant phenomena" and not "adverse effects," the average consumer would likely concur that those sometimes severe gastrointestinal effects are indeed "adverse effects." Some consumers would undoubtedly associate their adverse effects with consumption of olestra, but many others might not. Furthermore, it is highly inappropriate for the FDA to permit a laxative food additive to be used in foods that would be widely consumed by a large fraction of the population. Likewise, even though the benefits of carotenoids and other non-vitamin phytochemicals are just beginning to be understood, many independent researchers concerned about carotenoids have told the FDA that reduced levels of those dietary substances should be considered an adverse effect.

Any benefits of olestra do not outweigh the risks. Industry and the public have been excited about olestra because of the possibility that it would help people eat diets lower in fat and saturated fat — and prevent obesity and heart disease. The current petition asks for use of olestra only in potato chips and similar foods. A person who ate an ounce of potato chips only occasionally would receive little calorie-saving from olestra-containing chips. A frequent chip-eater would save more fat, but would also experience a substantial decline in carotenoids and other phytochemicals (along with an increased risk of macular degeneration and possibly cancer and heart disease) and might experience gastrointestinal problems. Poorly nourished people, Coumadin-users, and other subgroups might experience additional problems. On balance, olestra's meager benefits are outweighed by its risks. Of course, people who wanted safe fat-free or lowfat chips can simply choose from the growing variety of such products already on the market.

_________________________________________

Listening to corporate NPR/APM I heard a report that addressed the growing appearance of salmonella outbreaks because after all------OUR MEAT PROCESSING PLANTS ARE THIRD WORLD WITH NO OVERSIGHT AND REGULATION.  Since Obama came onboard-------oversight agencies are being dismantled faster than with Bush.  The corporate reporter simply said -----JUST COOK THE MEAT LONGER AND DON'T WASH IT!  That was our public health announcement.  This dismantling of oversight and deregulation of food industry is just another step towards Trans Pacific Trade Pact that allows foods from developing countries into America having the worst of health issues.  Neo-liberals are saying

------THE GOAL IS MAXIMIZING PROFITS FOR US GLOBAL AGRICULTURE AND MEAT IN OVERSEAS MARKETS----WHO CARES ABOUT THE HEALTH OF THE AMERICAN PEOPLE.

These are pols you are electing as democrats folks~

As I showed earlier, Trans Pacific Trade Pact TPP has Obama and neo-liberals overseas demanding nations that partner in this allow antiobiotics and hormones in their nation's food supply even as we know it is a health crisis in America.  This is what dismantling public health looks like.  Normally, the Department of Health and Human Services at Federal and State level would be shouting against all of these policies as harmful to public health----but they are silent.  That is what dismantling public health does -----no public advocate.


New salmonella outbreak in chicken resists antibiotics Elizabeth Weise , USA TODAY 7:35 p.m. EDT October 8, 2013

A salmonella outbreak linked to raw chicken from California involves several antibiotic-resistant strains of the disease and has put at least 42% of the victims in the hospital, the Centers for Disease Control and Prevention said Tuesday.

"That's a high percentage," said CDC spokeswoman Barbara Reynolds. "You would expect about 20% hospitalizations with salmonella Heidelberg."

There have been no deaths linked to the outbreak.

Thirteen percent of those sickened have salmonella septicemia, a serious, life-threatening whole-body inflammation, said Caroline Smith DeWaal, food safety director of the Center for Science in the Public Interest in Washington.

DeWaal was briefed by Christopher Braden, director of the division of food-borne illness at the CDC.

"This outbreak shows that it is a terrible time for government public health officials to be locked out of their offices and labs, and for government websites to go dark," she said.

As of Tuesday, 278 people in 18 states have been sickened in the salmonella Heidelberg outbreak. Interviews with some of the patients have linked it to chicken produced by Foster Farms at three California plants, the U.S. Department of Agriculture (USDA) said Monday.

The CDC has been hampered in tracing the outbreak because the government shutdown meant the agency had to shut down PulseNet, a national network of public health laboratories that looks for trends and matches reports to spot food-borne illness outbreaks. It's one of the agency's most important tools in detecting such problems.

"We were trying to do this without the automatic system, and it was nearly impossible," Reynolds said. Seven of the eight staffers who run the system were furloughed. "We were doing it by hand, and it just become untenable."

CDC director Thomas Frieden determined that not having PulseNet was resulting in "an imminent threat to health and safety," a finding that allowed the agency to bring back the seven staffers, Reynolds said Tuesday. "It's back up and running as of today."

There are seven strains of salmonella Heidelberg involved in the outbreak, and some are resistant to some commonly used antibodies. That makes it a very "complex" outbreak, Reynolds said.

"The salmonella strains are showing resistance to multiple antibiotics, and that means more people are going to the hospital and their infections will be harder for physicians to treat," DeWaal said.

The USDA's public health alert named three facilities operated by Foster Farms as the likely source of raw chicken contaminated with salmonella. Most of it was sold in California, Oregon and Washington, and most of the illnesses have been in California, the USDA said.

In an emailed statement, a Foster Farms spokeswoman said, "consumers should know that the frontline antibiotics used to treat salmonella are fully effective in treating the illness."

Congresswoman Louise Slaughter took strong exception to that. "They have no ground to stand on to make that statement," she said. Slaughter has been an outspoken advocate for ending the routine feeding of antibiotics to animals to promote growth, a practice which FDA and CDC agree can breed antibiotic resistant strains of disease.

Frontline antibiotics aren't all working in this outbreak, she said. "These Heidelberg strains are resistant to multiple antibiotics, including ampicillin, chloramphenicol, tetracycline and streptomycin."

The chicken has not been recalled because the agency's Food Safety and Inspection Service "is unable to link the illnesses to a specific product and a specific production period," the news release says. Consumers can identify products that came from the three plants by looking for these packaging codes: P6137, P6137A and P7632.

In its own news release, Foster Farms said it is working with USDA inspectors and the CDC. The company's food safety chief, Robert O'Connor, said USDA inspections have not been affected by the federal government shutdown.

Common symptoms of salmonella food poisoning include diarrhea, cramps and fever that typically start eight to 72 hours after eating food with high levels of the bacteria. Some people get chills, nausea and vomiting, lasting up to seven days, the USDA says. For people with weak immune systems, including infants and the elderly, the infection can be deadly.

Foster Farms encouraged consumers to cook poultry to an internal temperature of 165 degrees to kill disease-carrying pathogens. The USDA recommends that consumers use a food thermometer as the only way to be sure the proper temperature is reached.

An outbreak of one of the same strains of salmonella was linked to Foster Farms chicken in 2012 in Oregon and Washington. That outbreak sickened 134 people in 13 states, the CDC reported this year.

In a statement on its website, Foster Farms said it has "instituted a number of additional food safety practices, processes and technology throughout company facilities that have already proven effective in controlling salmonella in its Pacific Northwest operations earlier this year."

Salmonella is known to contaminate poultry flocks in the USA.

"Salmonella is naturally occurring in poultry and can be fully eradicated if raw product is properly handled and fully cooked," O'Connor of Foster Farms said.

Several European countries have succeeded in eradicating it by stringent testing and eliminating any flock with an infected bird, but that is considered too costly to implement in the USA.

Contributing: Kim Painter

________________________________________


Remember, if neo-liberals are pushing hormones and antibiotics overseas----they have no intent in ridding the US of this public health disaster.  The joke in circles of the rich---an epidemic could take millions of people from an overpopulated planet.  The stage for epidemic has been set by Clinton and now Obama.  Democrats work for the people and republicans work for wealth and profit.  Neo-liberals are republicans.

Dismantling food safety in the US is necessary when the goal is to flood US markets with food from countries having no health standards.  That is what neo-liberalism has done from Reagan/Clinton and now Obama.  LET THE PEOPLE DIE----THIS IS ABOUT PROFITS!


Published on Thursday, August 22, 2013 by OtherWords

The Un-American Way: On the Anti-Democratic 'Trans-Pacific Partnership' Why the TPP deal threatens food safety and public health
by Wenonah Hauter

The United States is negotiating a NAFTA-style trade deal that should be alarming to American consumers. The main reason it’s not getting much attention is that the mainstream media is largely ignoring it.(GlobalTradeWatch/Flickr)

This pact deserves more news coverage. It threatens to undermine our own laws and increase the opportunity for corporate takeovers of public resources in the United States and abroad. The worst part? These negotiations are taking place behind closed doors.

This controversial agreement is called the Trans-Pacific Partnership (TPP). It’s comprised of the United States plus 11 other nations that border the Pacific Ocean. The TPP would boost liquefied natural gas exports and food imports. This increases the real dangers posed by reckless fracking for natural gas and the growth of imported food from several countries whose safety standards fall far short of our own.

The TPP could become the biggest corporate power grab in U.S. history. This deal would establish a regime under which corporations would acquire an equal status to countries, allowing them to take legal action against governments both at the national and local levels.

With this power, multinational corporations — especially energy companies — could overturn laws enacted to protect the public and the environment if they were to deem that those protections violated the profit-based terms of this trade agreement.

The United States currently has enough challenges plaguing our food system, with many of our would-be TPP partners shipping unsafe food even without these so-called free-trade agreements. Seafood imports alone have been particularly troubling. Much of the seafood we import is farm-raised using antibiotics and hormones that are illegal in our own country, and a mere 2 percent of those imports are actually inspected by the FDA.

The TPP would encourage increasing the amount of seafood we take in without requiring the trading partners to ban the use of illegal chemicals.

This could also hurt the American consumers through the expansion of the oil and gas industry, as it tries to increase its land use at home to frack more gas for export to our new TPP partners.

This pact could quickly undermine local, state, and even federal laws that protect public health and the environment. Many localities have recently passed laws to ban fracking. Unfortunately, a lot of the companies that are pursuing hydraulic fracturing in the U.S. are either foreign-owned or have foreign investors.

The TPP would potentially give companies the power to sue local governments, granting them their own permission to exploit natural resources and undermine local laws.

Treaties like the TPP undermine important efforts by grassroots movements and governments to protect people and the environment against the dangers of infecting our food system with increased use of antibiotics and hormones or the risks associated with fracking for natural gas.

Protests against this trade accord have already gotten started in other countries, including Japan and Malaysia, as concerns grow over its expected negative effects. The bottom line is that TPP will bring little, if any, benefit to small-scale growers and producers.

As negotiations near completion, it’s critical that we let our members of Congress know that we don’t support this kind of corporate power grab. President Barack Obama is asking Congress to grant “fast-track” authority, allowing him to negotiate the TPP and other trade deals without otherwise requisite congressional oversight. We must stop that from happening.

Undermining laws that U.S. citizens voted to put in place isn’t the American way.

This work is licensed under a Creative Commons Attribution-Share Alike 3.0 License Wenonah Hauter is the executive director of the consumer advocacy group Food & Water Watch. She has worked extensively on energy, food, water and environmental issues at the national, state and local level. Experienced in developing policy positions and legislative strategies, she is also a skilled and accomplished organizer, having lobbied and developed grassroots field strategy and action plans.

__________________________________________

The most disturbing issue with health care being profit-driven is there are no limits to what can be done.  Whether it is Wall Street creating bets on people's life insurance and when they die-----or whether it is the large US global health systems as we have in Baltimore with Johns Hopkins acting in HEALTH TOURISM where the goal is to attract the rich of the world to your institution------all of this making ethics and morality fly out the door as it does in finance.  Johns Hopkins Medical System has been sited once for involvement in illegal organ procurement and citizens of Baltimore for years have said that the poor suspect organ harvesting at Johns Hopkins.

RAISE YOUR HANDS IF YOU DO NOT BELIEVE PROFIT-DRIVEN HEALTH TOURISM WILL BRING THESE MORALLY REPREHENSIBLE ACTIONS TO THE US------EVERYONE BELIEVES THIS!

We know this is already happening in the US and it is because public health systems are being dismantled at the Federal and state level.  Baltimore has NO PUBLIC HEALTH after O'Malley and now Rawlings-Blake allowed Sharfstein and Barbot privatize all of public health to private corporate non-profits.

CINDY WALSH FOR GOVERNOR WILL REVERSE THIS PRIVATE HEALTH SYSTEM WITH EXPANDED AND IMPROVED MEDICARE FOR ALL AND REBUILD PUBLIC HEALTH AGENCIES AND PROTECTIONS FOR THE PEOPLE!


Child Organ Harvesting And Trafficking-Linked Arrest Made In Mexico 

| by  OLGA R. RODRIGUEZ Posted: 03/17/2014 10:22 pm EDT Updated: 03/18/2014 8:59 am EDT
MEXICO CITY (AP) — Huffington Post

Police in Mexico's western state of Michoacan detained an alleged member of the Knights Templar cartel who is suspected of kidnapping children to harvest their organs, an official said Monday.

Michoacan state Public Safety Secretary Carlos Castellanos Becerra alleged that Manuel Plancarte Gaspar was part of the cartel's organ-trafficking ring. The ring would kidnap children and take them to rented homes with medical equipment where their organs were removed, Castellanos Becerra charged.

"We have several statements in open investigations that point to a network of several suspects who would identify people with certain characteristics, especially children, and kidnap them," he said.

Castellanos Becerra said the cases go back several years, but he said he couldn't give any specific details or discuss evidence because the investigation is still open.

Plancarte Gaspar, 34, was detained last week along with another suspect in a stolen car. The men also had some crystal meth, Castellanos Becerra said. He said Plancarte Gaspar is the nephew of Enrique Plancarte Solis, a top Knights Templar leader.

Hours before the announcement, a leader of one of the local vigilante groups that sprang up last year in Michoacan to challenge the cartel's control told a radio station that people in the area knew the Knights Templar gang was involved in organ trafficking because several children had been rescued in his town while being transported in a refrigerated container inside a van.

"They were inside a refrigerated box, tightly wrapped in blankets," Dr. Jose Manuel Mireles, leader of the civilian "self-defense" group in Tepalcatepec, said in a morning interview with MVS radio.

Mireles said the van carrying the children was headed to the port city of Lazaro Cardenas and ended up in Tepalcatepec after making a wrong turn.

"They were all children from the same Mexico City school," he said.

He said the children's parents had allowed them to go on an outing to the beach when they were likely kidnapped. He said the children were turned over to their parents who traveled to Tepalcatepec.

Mireles didn't say when the children were rescued and didn't answer his cellphone Monday.

Mexican authorities have said drug trafficking is no longer the top source of income for the Knights Templar, which was once a top producer of crystal meth. The officials say the cartel's main sources of income are illegal mining, illegal logging and extortion.

PLEASE CHECK MY SUNDAY POST!


THERE IS GOOD NEWS FROM THE FAILURE OF MARYLAND HEALTH SYSTEM DESIGNED TO END FEDERAL PROGRAMS MEDICARE, MEDICAID, AND PUBLIC SECTOR HEALTH PLANS.....PEOPLE HAVE TIME TO SEE THE DAMAGE AFFORDABLE CARE ACT DOES TO THE AMERICAN PEOPLE AND THEY ALL NOW WANT EXPANDED AND IMPROVED MEDICARE FOR ALL!

We are listening today on corporate NPR/APM and WYPR our local politician Elijiah Cummings heap praise on departing Kathleen Sebelius of Department of Health fame.  Here is a politician from the most conservative republican state in the country-----Kansas given the job of developing and implementing a health care reform, the ACA that ends public health and hands the American people over to health institutions writing health law to maximize corporate profit.  Kathleen was a state insurance commissioner in a state where politicians work for the industries they regulate-----you know like Wall Street regulatory agencies.  Yet, this dye-in-the-wool conservative republican state pol was selected by Obama and praised by Cummings for her work in privatizing all public health and both Obama and Cummings run as democrats.

WHEN A POLITICIAN RUNS AS A PROGRESSIVE LABOR AND JUSTICE CANDIDATE AND THEN APPOINTS AND PRAISES POLS FROM THE MOST CONSERVATIVE OF STATES-----THEY ARE NOT DEMOCRATS!


Kathleen Sebelius

Kansas House of Representatives (1987–1995)
Kansas Insurance Commissioner (1995–2003)Governor of Kansas (2003–2009)


Political Pundits: Is Kansas The Most Conservative State?

By Stephen Steigman & Steve Kraske

If there was any doubt about the hold of the political right in the Heartland then wonder no more.  A recent survey shows Kansas has the most conservative congressional delegation in the nation.


WHY IS THAT?  IT IS BECAUSE OBAMA AND CUMMINGS ARE GLOBAL CORPORATE POLS WORKING FOR WEALTH AN PROFIT JUST AS REPUBLICANS DO----THEY ARE NOT DEMOCRATS!

GANSLER, BROWN, AND MIZEUR ALL SUPPORT AND WILL CONTINUE THE DISMANTLING OF OUR PUBLIC HEALTH BECAUSE THEY ARE ALL GLOBAL CORPORATE POLS.

Remember, the Federal program Medicare has decades of health data that can easily show how much each medical procedure costs all over the nation, can assess what the best cost would be in balance of patient access and corporate profit and yet, none of this factors as corporate democrats hand this health reform to corporations to write and patient access and health care labor are of course the losers.  When you listen to corporate NPR/APM you are listening to republicans and corporate neo-liberals both working for the same goal----they represent 5% of the nation as even republican voters hate global corporate pols.



As I have said there are well-developed plans already developed for Expanded and Improved Medicare for All.  Any politician could run for Governor of Maryland and simply use existing policy and planning to implement.  Do not allow neo-liberals to tell you it can't be done because simply building oversight into Medicare health system will end 1/2 of expenditures just by ending fraud and profiteering!  These neo-liberals have wasted hundreds of billions of dollars developing this private system simply to make health care a global profit-maximizing industry and WE WILL TAKE IT BACK!!!!


How does the State of Maryland move to Expanded and Improved Medicare for All?


Still think the plan was not to end Medicare and Medicaid as Federal programs by sending them all to state health systems that dismantle all Federal protections for public health?

Private health plans have no intention of coming into these exchanges because they are well on their way to going global with the deregulation of the Affordable Care Act they will be just as unaccountable as Wall Street and just as criminal and corrupt.  What you see are private companies being created under the guise of private non-profits like EVERGREEN owned and run by Johns Hopkins under Beilenson.  So, these private non-profits will end up with all of Medicare, Medicaid, and public sector health plans ending these Federal programs and with de-regulation and no public health protections....health care for most will become charity work if these people have their way.

ALL ACROSS THE  COUNTRY THE MOST HEALTH ACCOUNTS BEING CREATED ARE FOR MEDICAID....AS IN MARYLAND.

Below you see where advocates of Medicare out Medicare Part D as the start of privatization and Affordable Care Act heavily funds Medicare Part D making it the plan seniors must go to to get medication they can afford.  Creating state health systems sets the stage for Medicare and Medicaid programs to end at the Federal level and become what is looking like Medicaid for All.  Only, Medicaid was gutted at Federal and State level and does not exist as a Federal program.......while most people in the US are falling into this category.



The Privatization of Medicare
V I E W P O I N T

Medicare is the federal health insurance program that provides coverage to 43 million Americans who are age 65 and older or who are younger than 65 and receiving Social Security disability payments. Traditional Medicare consists of hospital insurance, Part A, and supplementary medical insurance, Part B. Every Medicare beneficiary has the same cost-sharing amounts and benefit structure under both Parts A and B. Premiums were originally uniform, but Part B premiums have been increased for higher-income beneficiaries.

The Medicare Part D prescription drug benefit, established by the Medicare Modernization Act of 2003 (MMA), differs dramatically from traditional Medicare. The MMA allows only private companies to participate in Medicare Part D, thus privatizing prescription drug coverage for America's seniors and eroding the social insurance nature of the Medicare program. Because of this privatized structure, beneficiaries pay different premiums and must choose between a very large number of plans with varying drug coverage and cost sharing amounts.

Despite the success and popularity of the traditional fee-for-service Medicare program, and the failure of past privatization efforts such as Medicare+Choice, the MMA greatly expanded the role of the private sector in Medicare. In addition to the prescription drug benefit that is delivered only by private stand-alone prescription drug plans or private Medicare Advantage (MA) plans, the law threatens traditional Medicare by overpaying private health insurance companies, means-testing the Part B premium, imposing a completely arbitrary 45 percent cap on general revenue financing of the Medicare program, and establishing a "premium support" demonstration to compare costs between fee-for-service Medicare and subsidized private plans.

NATIONAL COMMITTEE POSITION

Create a Medicare-operated prescription drug benefit with the government required to negotiate drug prices

Seniors should have the option of a Medicare prescription drug benefit rather than having to sort through countless private plans in order to receive prescription drug coverage. Seniors face too many plan choices with various premiums, deductibles and other cost-sharing amounts. A Medicare-operated drug benefit would offer the dual benefit of simplifying and standardizing the coverage provided by the program, and it could provide a more comprehensive formulary at uniform prices. Furthermore, unlike private companies, a government plan would not need to increase prices and change formularies throughout the year to maximize profits. Overall, traditional Medicare achieves administrative efficiencies not matched by private plans. Extending this efficiency to the Part D program will save taxpayer dollars.

Require the federal government to negotiate drug prices

The federal government should be required to use leverage through negotiating in bulk to negotiate lower drugs prices for the Part D program. States currently use this leverage to negotiate lower prices for their health care programs, as does the Department of Veterans Affairs. It would be easiest to achieve effective price negotiation under a Medicare-operated drug benefit, but there are a number of alternatives by which CMS could effectively achieve lower prices for private plans as well.

Level the playing field between traditional Medicare and private Medicare Advantage plans

Private plans should be paid at the same rate that the traditional Medicare program is paid for covering beneficiaries. However, due to provisions of the Medicare Modernization Act of 2003 (MMA), private Medicare Advantage plans are now paid an average of 14 percent more than traditional Medicare. Inflated payments to Medicare Advantage plans, which amount to $15 billion a year, are funded by all taxpayers and all Medicare beneficiaries, not just the 20 percent of Medicare beneficiaries enrolled in private plans. Equalizing Medicare payments would save about $169 billion over ten years, reduce Medicare Part B premiums by $3.00 a month per beneficiary and bring an additional 18 months of solvency to the Medicare hospital trust fund. Better uses of the money would be to improve the Part D benefit by reducing costs to seniors, including filling-in the so-called "donut hole" that requires beneficiaries to pay 100% of the cost of their prescription drugs while continuing to pay full premiums to private plans; and enhancing benefits in traditional Medicare.

Repeal the means-testing of Part B premiums

Medicare beneficiaries with incomes above certain levels are paying higher Part B premiums due to passage of the Medicare Modernization Act of 2003 (MMA). Prior to 2007, all Medicare beneficiaries paid premiums equal to about 25 percent of the Part B program's average cost per beneficiary. Today, higher-income seniors are paying premiums ranging from 35 to 80 percent of the average per beneficiary cost which translates into premiums that are double or triple the standard premium amount.

Means-testing undermines the social insurance nature of the Medicare program and could lead to increased costs for middle- and lower-income seniors if higher-income seniors, who are often younger and healthier, are driven away by increased cost-sharing. It also raises premiums for those who have paid the most into the program through Medicare payroll taxes, harms seniors and their families regardless of their financial obligations, and puts the burden on seniors to demonstrate that their premiums should not be increased if their income is reduced.

Repeal the 45 percent cap on general revenue funding for Medicare

The Medicare Modernization Act imposed a completely arbitrary cap of 45 percent on general revenue financing of the Medicare program. When the Medicare Trustees project, for two consecutive years, that 45 percent of Medicare funding will come from general revenues at a set future date, the President is required to present a plan to Congress to reduce general revenue funding. This approach would prevent consideration of all potential solutions to the program's long-term shortfall. Further, it ignores Medicare's financing structure, which is designed to include substantial contributions from general revenues to fund Medicare Parts B and D, as well as the need to address Medicare's future in the context of U. S. health policy as a whole. The National Committee supports the House of Representatives' decision to suspend the 45 percent rule for the 111th Congress and urges its permanent repeal.

Prevent implementation of the 2010 comparative cost adjustment demonstration

The "comparative cost adjustment demonstration project" - also known as "premium support" - established in the Medicare Modernization Act requires traditional fee-for-service Medicare to compete with private Medicare Advantage plans in selected regions beginning in 2010. Seniors will receive the equivalent of a voucher in an amount reflecting the average per beneficiary cost of private plans and traditional Medicare for their region. If they enroll in a less expensive plan, either a private plan or traditional Medicare, they can keep a portion of the savings; if their plans' premiums or the traditional Medicare Part B costs are higher, they will pay the difference out-of-pocket.

Proponents of the comparative costs adjustment demonstration project claim that this competition will result in better benefits to seniors at lower cost. Healthier seniors who enroll in subsidized Medicare Advantage plans, which are overpaid compared to the traditional Medicare program, may do better in such a system for a time. Older, sicker seniors are more likely to remain in traditional Medicare where they are certain of the benefits it provides and they can continue seeing the doctors they know. However, because the risk of insuring these seniors would be spread among many fewer people, it is inevitable that they will end up paying higher Part B premiums than beneficiaries who are not in comparative cost adjustment areas. At the same time, they are subsidizing the private companies that drain healthier retirees from their risk pool and further increase their costs. This privatization experiment would likely move Medicare beneficiaries out of traditional Medicare and into private health plans thus further eroding the social insurance nature of Medicare.

CONCLUSION

Forty years after its enactment, Medicare, along with Social Security, remain our most popular and essential federal social insurance programs. Any changes in Medicare must not alter the fundamental social insurance principle that has made Medicare such a popular and effective program.

The National Committee to Preserve Social Security and Medicare will continue to advocate for expanding traditional fee-for-service Medicare to include a prescription drug benefit with the government negotiating drug prices. The National Committee is also dedicated to leveling the playing field between traditional fee-for-service Medicare and private Medicare Advantage plans in order to enhance benefits for all Medicare beneficiaries and to make the best use of all Medicare expenditures. In addition, the National Committee will continue to oppose initiatives such as means-testing premiums and the "premium support demonstration" that likely could result in a two-tiered Medicare program based on income and health status.

 

Government Relations and Policy, March 2009


_______________________________________________

We are hearing all across the country that most people are being pushed into Medicaid level plans that will only offer preventative care.  As corporations shed their health plans and as Medicare and public sector pensions are ended and thrown into these private health systems, most people will fall into these Medicaid/Bronze level health plans with only preventative access.

If this is allowed to continue life expectancy in the US will drop dramatically in just one generation.  IT IS A CATASTROPHE FOR A DEVELOPED WORLD TO PUSH 80% OF ITS CITIZENS INTO THIRD WORLD LEVELS OF HEALTH CARE AS THE AFFORDABLE CARE ACT PLANS TO DO!





Tue, Jan 14, 2014, 8:28 AM EST -

63 percent of RI insurance sign-ups for Medicaid 63 percent of insurance sign-ups during first 3 months of HealthSource RI were for Medicaid

By Erika Niedowski, Associated Press

16 hours ago
HealthSource RI said that 11,770 individuals enrolled in commercial plans between Oct. 1, when the marketplace opened, and Jan. 4. The state Health and Human Services office said 19,941 enrolled in Medicaid during the same period.

Of those who enrolled for private coverage, 9,902 have paid and had coverage begin this month, according to HealthSource RI.

The marketplace, sometimes known as an exchange, also released new demographic data that show who is using it and what type of coverage they are choosing.

One-third of individual private-plan enrollees are 55 and older; 23 percent are 18 to 34. The overwhelming majority of those who signed up chose a Blue Cross & Blue Shield of Rhode Island plan. Fifty-six percent chose a "silver" plan over bronze, gold and platinum.

Eighty-seven percent are receiving some kind of subsidies for the coverage.

It's not clear how many of those who enrolled in private plans were previously uninsured.

Most Americans are now required to have health insurance under the federal Affordable Care Act, or pay a penalty. There are more than 120,000 uninsured in Rhode Island in a population of just over 1 million.

The state has not publicly released enrollment targets for the first sign-up period, but the U.S. Centers for Medicaid and Medicare Services set a goal of 5,640 enrollments in Rhode Island by Dec. 31 and 12,000 by March 31.

HealthSource RI also reported Monday that 75 small businesses have enrolled, representing 530 employees. The state is putting a lot of emphasis on getting small businesses to sign up.

The marketplace is offering 12 individual plans and 16 small-group plans in 2014.

The deadline to pay for coverage beginning Jan. 1 already passed, but open enrollment is continuing through March 31. The next deadline to select and pay for a plan is Jan. 23.
________________________________________

Did you know that HUMANA is a private health plan that seeks to draw seniors out of the public Medicare by front-loading these plans with perks but in the longer term will undermine this strong Federal program and it is deliberate?

If people understand what Maryland's Medicare exemption from Federal oversight means you will see why Hopkins is tied with a private senior health care corporation.  Hopkins' goal in health policy is to maximize health profits and when they requests these exemptions from Medicare they are telling us they are making Medicare more cost effective.  What they are doing is creating the tiered system of payments to Medicare patients and procedures that has systematically made Maryland's hospitals the worst in the nation as far as quality care and performance.  Just finished surgery on you leg under anesthesia and still haven't fully woken from this procedure after a few hours?

TOO BAD BECAUSE YOUR TIME IS UP AND YOU ARE OUT THE DOOR.  WHAT???  NO ONE AT HOME TO MAKE SURE YOU HAVE NO ILL EFFECTS FROM THE SURGERY?  HIRE A HOME HEALTH PERSON TO COME SIT WITH YOU ---YOUR TIME IS UP HERE IN MEDSTAR!!!!

We had surgery and implanted a steel plate for your broken bone that once simply had a cast placed on it because the bone had a fracture that needed support.  The patient asks to see the X-RAY and straining his eyes looking for a fracture because there is none is told by the doctor-----IT'S THERE!

Need a doctor that handles Medicare?????  There is a compound for senior care on the outskirts of the city with national health chains.....GO THERE! 

This is how Hopkins has made Maryland's health businesses the most profitable in the nation and these new approaches are what the Affordable Care Act is based upon.  It is diabolical!!!!

I DO NOT HAVE TO TELL BALTIMORE CITIZENS THAT PEOPLE ARE FEARFUL OF ENTERING JOHNS HOPKINS AND CALL MEDSTAR A DEATH TRAP BECAUSE OF WHAT THESE LONG-TERM HEALTH POLICIES HAVE DONE TO MARYLAND'S HEALTH SYSTEM....SO, AS HOPKINS TOUTS ITSELF OVER AND AGAIN AS THE BEST IN THE WORLD IN EVERYTHING....KNOW THAT THEY ARE NO DOUBT BUYING THEIR RANKING FROM THE LIKES OF US NEWS AND WOLD REPORT!



HUMANA AND JOHNS HOPKINS TEAM UP WITH MANAGED-CARE NETWORK



BALTIMORE, Dec. 1 /PRNewswire/ --

Humana Inc., one of the nation's largest health maintenance organizations, and Johns Hopkins, one of the premier medical centers in the country, are teaming up to form physician networks throughout the state of Maryland.

Humana members also will be able to use Johns Hopkins hospitals and facilities in the state.

"This strategic affiliation is the first of its kind for Johns Hopkins," Health System President and CEO James A. Block, M.D., said. "We are tremendously pleased to be able to work with Humana, not least because of its experience nationwide in serving a managed-care population covered by Medicare."

The affiliation is between Johns Hopkins HealthCare LLC, led by John D. Stobo, M.D., which represents The Johns Hopkins Health System and The Johns Hopkins University School of Medicine, and Human Group Health Plan, Inc. of Washington, D.C., a wholly-owned subsidiary of Humana Inc.

Humana will use primary and specialty physician networks being formed by Johns Hopkins, such as the Wilmer Eye Network and networks in cardiology and pediatrics, and work with Johns Hopkins to develop a full complement of other networks in the state.

"This relationship with a medical center that has an international reputation for quality and innovation is terrific news for Humana and its members," said Humana Senior Vice President Phil Garmon, who also noted that Johns Hopkins Hospital has been rated best in the country for five consecutive years by "U.S. News & World Report" and more faculty physicians from its school of medicine than any other have been listed in the book, "Best Doctors in America." "It should be a mutually beneficial relationship for both parties. Humana obtains access to networks of quality physicians and high caliber medical facilities in Maryland and Johns Hopkins can utilize our many years of experience in managed care to develop and expand its networks."

Michael E. Johns, M.D., dean of the School of Medicine, added that, "As Humana's enrollment grows in central Maryland, this agreement will serve to heighten access to the faculty practice at Hopkins. This is another vote of confidence from a leading managed-care organization for the way in which we are responding to the changing health-care marketplace."

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly-owned HMO companies with more than 3.8 million members in 22 states and the District of Columbia. Humana offers quality and affordable coordinated care in the form of HMOs, preferred provider organizations, point-of-service organizations, along with administrative-only services. In addition, Humana is one of the nation's largest providers of "HMO-style" health care to seniors through its federally approved Medicare products. -0- 12/1/95
____________________________________________
As I have said there are well-developed plans already developed for Expanded and Improved Medicare for All.  Any politician could run for Governor of Maryland and simply use existing policy and planning to implement.  Do not allow neo-liberals to tell you it can't be done because simply building oversight into Medicare health system will end 1/2 of expenditures just by ending fraud and profiteering!  These neo-liberals have wasted hundreds of billions of dollars developing this private system simply to make health care a global profit-maximizing industry and WE WILL TAKE IT BACK!!!!

National Physicians has a well-researched plan that will reverse this Wall Street takeover.  I want to acknowledge that while I believe these physicians are working for all of us....I do want to make sure that this is universal and equal and addresses massive health industry fraud and profiteering and is not only funded by more taxes on the public!  When I read that Vermont's will include Tort reform as a way to lower cost I know that the reasons Doctor's Malpractice insurance is so high is that the American Medical Association does not police or hold accountable the doctors repeatedly performing badly....it is just like these other white collar crimes that get hidden and moved around. 

TORT REFORM SHOULD NOT HAPPEN UNTIL THE AMA HAS PROVEN THAT IT IS POLICING THE MEDICAL PROFESSIONALS AND ARE TRANSPARENT TO THE PUBLIC!!!!!

Please take time to read the entire article below!

A National Health Program for the United States: A Physicians' Proposal
Reprinted from the New England Journal of Medicine 320:102-108 (January 12), 1989

Abstract:

Our health care system is failing. Tens of millions of people are uninsured, costs are skyrocketing, and the bureaucracy is expanding. Patchwork reforms succeed only in exchanging old problems for new ones. It is time for basic change in American medicine. We propose a national health program that would (1) fully cover everyone under a single, comprehensive public insurance program; (2) pay hospitals and nursing homes a total (global) annual amount to cover all operating expenses; (3) fund capital costs through separate appropriations; (4) pay for physicians' services and ambulatory services in any of three ways: through fee-for-service payments with a simplified fee schedule and mandatory acceptance of the national health program payment as the total payment for a service or procedure (assignment), through global budgets for hospitals and clinics employing salaried physicians, or on a per capital basis (capitation); (5) be funded, at least initially, from the same sources as at present, but with payments disbursed from a single pool; and (6) contain costs through savings on billing and bureaucracy, improved health planning, and the ability of the national health program, as the single payer for services to establish overall spending limits. Through this proposal, we hope to provide a pragmatic framework for public debate of fundamental health-policy reform. (N Engl J Med 1989; 320: 102-8.)

_____________________________________________

KEEP IN MIND MARYLAND'S PRIVATE HEALTH EXCHANGE IS THE MOST CORPORATE AND PROFIT-DRIVEN IN THE NATION AND THIS IS WHY OBAMA FRONT-LOADED CORPORATE DEMOCRATS IN MARYLAND WITH MONEY TO DEVELOP THE 'MODEL' FOR THE COUNTRY----JOHNS HOPKINS WROTE MUCH OF THE STATE'S POLICY.


The problems with MD's health exchange are not isolated,......all of MD public policy is a disaster because none of it is written by public advocates.....it is entirely written by the corporate 1% that make policy simply to move profit to the top....ergo, people are not placed in charge because of talent but because of having the 3 monkey syndrome.....SEE NO EVIL, HEAR NOT EVIL, SPEAK NO EVIL....public policy in policing, education, development are all failures and hundreds of billions of the state's revenue have been lost just during O'Malley's tenure as Mayor of Baltimore and now Governor of Maryland.

Remember, the goal with these state health systems is to end Medicare and Medicaid as Federal programs and dismantle them through state policy!  We want to be shouting for Expanded and Improved Medicare for All!!

Also, please know it is not the democratic party bringing these republican policies forward.....it is neo-liberals that have control of the democratic party.  We simply need to rebuild the democratic party by running labor and justice to reverse all of this attack on public health!

Also note that it is Beilenson  leading with a so-called private non-profit EVERGREEN that is designed to catch all of what was public sector Medicare, Medicaid, and public sector health plans.....AND HE IS JOHNS HOPKINS.

Below is what is happening with all of Maryland policy----the connected are throwing together businesses to capture all the wealth from taxpayer money building something we do not even need as Medicare already has a system!

'Both had expanded rapidly to build the Maryland site, expecting it could give them a foothold in the potentially lucrative health-exchange market'.

Maryland officials were warned for a year of problems with online health-insurance site


By Aaron C. Davis and Mary Pat Flaherty, Published: January 11   Washington Post

More than a year before Maryland launched its health insurance exchange, senior state officials failed to heed warnings that no one was ultimately accountable for the $170 million project and that the state lacked a plausible plan for how it would be ready by Oct. 1.

Over the following months, as political leaders continued to proclaim that the state’s exchange would be a national model, the system went through three different project managers, the feuding between contractors hired to build the online exchange devolved into lawsuits, and key people quit, including a top information technology official because, as he would later say, the project “was a disaster waiting to happen.”

The repeated warnings culminated days before the launch, with one from contractors testing the Web site that said it was “extremely unstable” and another from an outside consultant that urged state officials not to let residents enroll in health plans because there was “no clear picture” of what would happen when the exchange would turn on.

Within moments of its launch at noon Oct. 1, the Web site crashed in a calamitous debut that was supposed to be a crowning moment for Maryland officials who had embraced President Obama’s Affordable Care Act and pledged to build a state-run exchange that would be unparalleled.

Instead, by the next morning only four people had signed up using the Web site — and amazed that anyone had gotten through the system successfully, state officials contacted each of them to make sure they were real. The site’s problems continue to prevent Marylanders from signing up for health insurance. As of Friday, 20,358 people had selected private plans, and state officials have said they do not expect to come close to their initial goal of 150,000 by the end of March.

This report is based on a Washington Post review of thousands of pages of previously undisclosed documents, including e-mails, internal reports, audits and court records, along with interviews with dozens of current and former contractors, state officials and others. The review shows that the creation of the exchange was dysfunctional from the start and that there were repeated missteps at almost every level.

On the morning of Oct. 1, shortly after Obama had proclaimed that Maryland would lead the charge in signing up residents for new health-care plans, the director of the state’s health exchange was repeatedly rejected by the network before she became the first to log on, with the help of her IT staff.

Since then, an unknown number of Marylanders have experienced the same frustration with the Web site and have been prevented from signing up for health insurance.

As the state continues to try to fix the site, Gov. Martin O’Malley (D) and state lawmakers are working to enact emergency legislation to spend millions to help insure those who could not sign up and had to begin the year with no coverage.

With many Marylanders still facing frozen computer screens and error codes when they attempt to select insurance, O’Malley is expected this coming week to decline an offer by the Obama administration to temporarily take over parts of the troubled site, despite the urging of some state Democrats to embrace the move. This past week, O’Malley acknowledged that the rollout “did not meet our expectations” but said that many things have been fixed and the state’s site is improving.

It’s a situation far different than what O’Malley predicted on a sunny morning in March 2010, less than 24 hours after Obama signed the Affordable Care Act. O’Malley called reporters to the entrance of an Anne Arundel County emergency room to announce that Maryland would begin drafting plans to “immediately begin the work to ensure our state leads the nation.”

‘There is a risk . . .’

Of the 14 states that opted to build and run their own health-insurance marketplaces, Maryland was among the earliest and most enthusiastic supporters of what became known as “Obamacare.” And it became the second state, trailing California, to enact legislation creating an exchange.

Lt. Gov. Anthony G. Brown (D), the highest-ranking elected official charged with implementing the law, was invited to speak across the country about the state’s early success. The Obama administration began depositing tens of millions of dollars in state accounts to pay for development, thinking Maryland’s exchange might be built so early that other states could copy it.

But out of public view, reports of trouble started arriving.

The first came in the fall of 2012, just over a year before the exchange was to launch. Auditors from the Portland, Maine-based firm of BerryDunn found that exchange officials were missing early deadlines to begin building the IT backbone for the public Web site, known as the Maryland Health Connection. The exchange was supposed to have signed agreements with state agencies that would allow them to link data from sources such as Medicaid and the Department of Motor Vehicles to the nascent site. But most agencies had not heard from the exchange or were unaware that the work was even overdue. The findings were summarized in a Nov. 1, 2012, letter to the president of the Maryland Senate and the speaker of the House of Delegates.

Almost $9 million in federal money was set aside to pay BerryDunn to be the watchdog for the high-profile project, with the expectation that Maryland officials would use the assessments to correct course as needed. The Post obtained copies of the confidential documents.

At the exchange’s temporary offices in north Baltimore during the fall of 2012, no one could produce for BerryDunn standard project plans showing a timeline and checklist for how the main IT contractor, from Fargo, N.D., would get the job done. The exchange’s staff, then just seven full-time state employees and borrowed ones from other agencies, “may not be sufficient to complete the work,” BerryDunn said in a PowerPoint presentation delivered to senior state officials in December. Five of the presentation’s slides began with: “There is a risk . . .”

One proved particularly prescient: Maryland might build all of the components of its health-insurance exchange and then put them together and find out they do not work, the presenters said. It was a serious risk, because the state also did not appear to be leaving itself with enough time to “complete, verify and test all system components before go-live.”

The 10 months that remained before the launch would go by quickly, the consultant warned, but corrective action could get the project back on track.

Two of O’Malley’s Cabinet members, his senior IT advisers and leaders of the exchange received copies of the confidential monthly reports, according to distribution lists. The first was also summarized in the technically worded letter to lawmakers. Aides to the legislative leaders said that the significance of the warning was not clear at the time and that they never knew the outside audits continued.

Late in 2012, the consultant’s reports focused increasingly on warnings that no one seemed to be in charge. Maryland Health Secretary Joshua Sharfstein; Human Resources Secretary Ted Dallas, the Cabinet member in charge of Medicaid; and Rebecca Pearce, the exchange leader, tried to make decisions together. It was a “three-headed-monster. . . . The next meeting could overrule the last. It was classic, you know, nothing was moving,” said one official who spoke on the condition of anonymity for fear of reprisal.

Within the exchange, Pearce, who had been lured away from a top job at Kaiser Permanente to run the system, was jostling with her own project manager for day-to-day control. Sunny Raheja was a state contractor who preceded Pearce on the exchange and would go to Sharfstein for decisions, according to documents as well as exchange officials who witnessed the dysfunction.

Ultimately, Raheja, who declined to comment, was replaced, and Pearce brought in a Medicaid IT specialist to run the technical side.

As Pearce’s new project manager began, the outside auditor said there was still no dis­cern­ible plan for building the exchange, no oversight by the state and poor communication among the contractors hired to build the online site.

“There is also no overall Master Project Plan and schedule that is being utilized to manage the milestones and activities necessary for the entire program effort,” BerryDunn warned in a Feb. 25 report.

The consultant broke the project into 11 categories and began labeling them as red, yellow or green — seven were in red, four were in yellow.

“From our perspective, agreement on a consolidated work plan will need input from all . . . so that there is a common understanding of what needs to occur between now and Oct. 1, 2013.”

In e-mails, Pearce’s new project manager said the situation appeared untenable. He resigned after a month, and the third project manager in three months took over in April — with six months to go before the site would launch.

“I think the wheels came off very early on,” said Amir Segev, who was deputy IT director for the exchange from February to May.

Segev said he left after only a few months “because it was a disaster waiting to happen.”

Contractors at odds

By May, the Obama administration was deciding which states would be allowed to proceed with building their own exchanges and which ones it would force to use the federal exchange. The team gave Maryland a deadline of June 1 to prove a core task: Its rudimentary software would have to communicate with a data hub the federal government was building to let states check whether health-care enrollees were eligible for subsidies.

The month of May became a sprint to make the deadline.

On one of the last days before the deadline, a federal team arrived at the Maryland IT contractor’s office in Linthicum, south of Baltimore, and sat in the front row of the briefing room with computers at each desk and a projection screen on the wall.

One part of the screen showed a fake enrollee’s information being sent from Maryland; the other showed the response from the federal hub. The two connected, and Maryland passed. Despite the internal turmoil and negative audits, the state seemed to finally be on the right path.

Sharfstein, the state health secretary, and Pearce called together the production team. Pearce put her foot on a chair and thanked everyone with a deep sense of relief evident in her voice.

News of the success also passed quickly to Brown and O’Malley, who began touting it in public appearances.

But as they celebrated, feuding between the two contractors in charge of doing much of the technical work to get the Web site running was getting worse.

Shortly after it had won Maryland’s initial $50 million contract, Noridian Healthcare Solutions, a company that grew out of Medicare claims processing, hired a Florida company — run by a former executive of Noridian’s parent firm — that renamed itself EngagePoint.

Noridian and EngagePoint agreed to share profits for development of the exchange, according to court documents filed by the companies — a move that state officials said they were made aware of only much later.

But within months of joining forces, the two were fighting over costs.

By July, according to court documents, infighting had brought work to a near-standstill.

Meanwhile, the software used successfully to pass the June test had to be replaced with newer and untested versions needed to meet federal security requirements.

In an interview, Sharfstein said the dispute had become a major distraction by then.

“For a while, we tried to play marriage counselor, but it was clear these were two companies that couldn’t work together well,” he said.

And another federal test was looming.

On Aug. 26, five weeks before the launch date, Maryland faced its final major test with federal overseers, a more thorough demonstration of how each part of its system would work.

This one did not go as well.

When the test got to the part of having a fictitious person choose a health plan, the Web site crashed. It also could not fully send enrollment data to insurers or e-mail Marylanders when they successfully selected a plan — something it still cannot do.

BerryDunn, the consultant, said the state must “hold Noridian to scheduled” deadlines and make 65 other changes. The state, it warned, also needed to start focusing on contingencies, knowing some parts of the site were bound to fail.

On a weekend in early September, Sharfstein logged on to measure the problems for himself. “You don’t want to know what he thought,” Pearce relayed in a message to her team, according to a testing report.

Pearce would soon send an e-mail titled “12 days out,” pleading with contractors to finish the job after she visited their Linthicum office on the evening of Sept. 18 and found it nearly empty.

“There’s a management methodology that has 4 aspects: pamper/pull/push/pummel. I think I have tried all of them at some point during this process,” she wrote at 11:24 p.m. “Tonight I am begging . . . we have got to make this reality.”

The success of the exchange was also becoming freighted with political implications as Brown launched his campaign for governor. In an early-morning e-mail on Sept. 23, Sharfstein wrote to Pearce, under a subject line “from today’s [Baltimore] Sun.”

He pasted in a line from U.S. Sen. Barbara Mikulski’s endorsement of the lieutenant governor the day before: “While we’re fighting to save Obamacare, we know that in Maryland we have a health exchange that’s ready to go because of Anthony Brown,” the Maryland Democrat said.

Pearce forwarded the e-mail to the heads of Noridian and EngagePoint, adding one line: “It’s time to get this right. Now. Period.”

Noridian chief executive Tom McGraw responded with military sparseness: “Understood.”

Testers filed their final report on Sept. 13, calling the last version of the software they could review “extremely unstable.” Internal testing of one aspect of the site found 449 defects, almost half of which would probably trouble the final release.

‘What’s wrong?’

On a conference call at the start of the final week of September, senior aides gave O’Malley a high-level summary of expected troubles with the exchange.

The Web site would not allow some people to check for subsidies or to select plans, but everyone should at least be able to log on, he was told, according to several aides.

The governor ended the call, said John Griffin, his chief of staff, saying the state should “move forward.”

But two days later, Griffin requested that a roomful of aides to the governor and Brown vote on whether to proceed. Most gave the Oct. 1 launch a green light. The next day, O’Malley smiled as Obama visited Prince George’s County and praised state leaders for being ready to roll.

Just after midnight on Oct. 1, programmers in the Linthicum office listened through a speaker phone to the anxiety growing in Pearce’s voice as she tried to log on, according to several people on the call. The site was not yet viewable publicly, but it should have allowed her to sign on. If there was one part of the site everyone agreed would work, it was this.

They waited for a second try and then a third as she reentered her name and address. Everything was correct. “What’s wrong?” she demanded.

No one was sure. Someone noticed that Pearce had left blank a box for the four-digit extension of her Zip code. Maybe the computer code required every single data field to be filled in to proceed. Try adding that, one manager said.

Pearce did not know the extension to her Zip code. They listened as she Googled it and attempted a fourth sign-on.

Click. She was in.

At 8 a.m., the exchange was supposed to launch simultaneously with other states, but it froze. The exchange posted a message online asking residents to come back in four hours.

Finally, at noon, officials watched from a command center in Baltimore as about 10,000 people logged on to the site, pinging servers in Fargo.

Screens showed blank graphs that should fill with enrollees moving through each phase of the system: creating accounts, checking for subsidies, shopping for plans, purchasing.

The stroke of noon came and went. No one logged on. No one bought health care.

The next morning was scarcely better. In the subject line of an e-mail to fellow contractors at 6:53 a.m., Noridian’s McGraw typed “Maryland is Down,” and wrote,“We cannot get through.”

More than 24 hours after the launch, there were just four people who had selected plans and eight more who appeared to have logged on.

An IT contractor wrote to state officials on Oct. 2 wondering if the four were “legitimate,” since contractors could not even access the site. She questioned if they might be fictitious accounts from prior phases of testing.

But later that day, the exchange’s chief information officer responded with good news: “The team has researched the 4 records and have determined these are for real customers. 3 applicants and 1 dependent. Applications have been processed albeit very slowly and sporadically.”

Pearce, who resigned under pressure in December, declined to comment on many aspects of the exchange’s development but said the wholesale failure on Oct. 1 “was a complete surprise to all of us.”

“We didn’t know it would be broken when we turned it on,” she said.

The day after the failed launch, Pearce sent an e-mail to the heads of Noridian and EngagePoint demanding answers.

“Gentlemen,” she wrote. “As the executives in charge of this program I would like to understand from you exactly what is happening with the project, and what you are doing to address our issues.”

But by the end of the first week of October, relations between the two companies were so strained that Pearce and Sharfstein acted as go-betweens. After more weeks of fighting, EngagePoint, the subcontractor, made a bold proposal to state officials, urging them to allow it to take over the project entirely. Days later, Noridian instead fired EngagePoint, whose programmers packed up their laptops and left, leaving some of the software in Ukraine, where EngagePoint had hired programmers.

It was now up to Noridian to fix the site — with few employees certain of where to begin. It began making offers to hire back fired EngagePoint workers it said were key to fixing the site.

EngagePoint chief executive Pradeep Goel was aghast. “We are not going to respond to ridiculous emails from Noridian demanding our team members show up for work after being escorted out of the office,” Goel wrote to McGraw and Noridian’s attorneys on Oct. 26. “Are you people on crack cocaine?”

EngagePoint persuaded a judge to sign a restraining order that blocked Noridian from hiring back workers to fix the site. Noridian countersued, and the state entered the fray, siding with Noridian for the sake of Marylanders who needed a functioning site.

Through its attorney, Daniel Graham, Noridian declined to discuss its work with EngagePoint, citing the ongoing litigation. In a statement, the company said that “the complexity of this project has led to a number of major issues beyond what was anticipated.” But the company believes that recent improvements have made the system easier to use and said it “will continue to work with the State” to improve it further.

Karen See, a spokeswoman for EngagePoint, said the firm would not discuss its work, also citing the lawsuits.

The full effect of the failed project on the two companies remains unclear. Both had expanded rapidly to build the Maryland site, expecting it could give them a foothold in the potentially lucrative health-exchange market.

Before the launch, the state had allocated about $100 million in federal money for the construction of its exchange, and, according to one estimate, it has spent tens of millions more since Oct. 1. It is unclear how much of the added costs federal officials will agree to cover. But the bigger question is how many people the state can sign up.  IT'S THE MARYLAND APPROACH TO PUBLIC WORKS.....

Maryland’s next deadline is March 31, the date by which it expected 150,000 people to have used the site to select health insurance, excluding Medicaid. Officials have said the state will not meet that goal.

“It’s a problem for the people of Maryland, a problem for the people that Obamacare was supposed to help,” said Peter Beilenson, chief executive of the Evergreen Health Co-Op, a new Maryland insurer that launched its business on a bet that it could compete with the state’s bigger insurers on a smooth-running Maryland exchange.

The company had a waiting list of more than 1,000 people who were expected to sign up with it when the exchange turned on.

For months, however, it could barely sign up one. On its best day in recent weeks, its staff helped 10 people navigate Maryland’s site. Evergreen still has more than 1,000 people waiting to buy insurance.

Raise your hands if you think giving the government authority to force American citizens to take PHARMA under the guise of mental illness is a good idea-------NO ONE!!!!!!  Remember, your incumbent in Maryland voted for the NDAA national security law that allows the government to hold American citizens without charge for as long as they want.

  This is what they do in Iran and China to dissidents. 

What we are seeing is yet another money vehicle to build corporate infrastructure with taxpayer money that will end up helping almost none of the people it is directed to help.  Longevity in the US will drop in one generation from lack of access to health care for 80% of Americans.


Today, I'd like to speak to Medicare and health industry fraud that is already soaring with deregulated/consolidated health markets.  There will be no controlling global health industry just as our government says it cannot control banks.


Remember when we were told the idea of state health exchanges were to give consumers more access to information and that would increase competition? SURPRISE----THAT WAS NOT THE GOAL AT ALL.

MANDATING INSURANCE AND CONSOLIDATION AND DEREGULATION ARE THE GOALS OF ACA-----THAT'S A CORPORATE POL FOR YOU-----ALWAYS WORKING FOR WEALTH AND PROFIT.

As we watch Dr. Sharfstein of Maryland's health exchange debacle testify to Congress about the mess that is Maryland's health exchange please remember that throughout this process Sharfstein was arrogant in making the process behind closed doors......NO TRANSPARENCY ....and came out of public meetings conducted behind closed doors to tell those gathered that the details of how health institutions would be monitored for meeting Federal requirements and for oversight of the entire process would be developed at a later time.  He did not look to care about the descriptions of the tiered plans.  As the article below shows, Maryland is ranked again at the bottom in transparency in its health exchange.  Sharfstein told me-----THERE IS NO FRAUD IN HEALTH CARE.

With Medicare being folded into this Maryland private health system as if this Federal program did not exist-------THIS IS CRITICAL FOR SENIORS.  We have lost 1/2 of Medicare/Medicaid spending for these few decades and this pace will soar under these Affordable Care Act conditions.

MARYLAND DOES NOT RECOGNIZE MEDICARE AS A PROGRAM....IT HAS INTEGRATED IT INTO THE TIERED ACCESS GIVEN ALL MARYLAND CITIZENS.




Below you see a good report on the state of transparency in health system exchanges.  Please Google it.  Remember, we were told the point of these exchanges was transparency for the consumer......MARYLAND AS ALWAYS IS SHOWN WITH AN 'F'.

States Fail the Grade on Health Care Price

Transparencywww.governing.com

Despite the growing number of laws that require publicly available health care pricing for consumers, most states fail the test of transparency, according to a new report from the Health Care..

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Seniors know the most expensive costs to health care can be PHARMA and as I showed in my last blog neo-liberals and Obama are pushing hard to make sure PHARMA maximizes profits all over the world, so you can bet here in America citizens will not be able to access ordinary drugs with the Affordable Care Act.  Medicare Part D was created by George Bush to end the Federal program  Medicare by making Americans have to leave the Federal program in order to afford PHARMA.  Policies like Medicare Advantage are private health plans designed to end Medicare.  You can bet once they get most people onto these private PHARMA plans----these plans will disappear.

MEDICARE ADVANTAGE AND MEDICARE PART D ARE ONLY MEANT TO END THE FEDERAL PROGRAM MEDICARE.

This is why neo-liberals doubled-down on funding Medicare Part D as they work hard to make PHARMA as expensive as possible.  This is bad for you and me, not good.

Don't worry that Maryland politicians and the people they appoint to manage Maryland Department of Health cannot see entitlement fraud -----CHINA IS DOING THIS FOR THE WORLD.

THIS IS HOW RIDICULOUS THE LEVEL OF FRAUD AND CORRUPTION IN AMERICAN CORPORATIONS HAS GOTTEN.  THE CITIZENS OF AMERICA ARE REDUCED TO BEING PROTECTED BY ONE NATION WANTING TO CORNER PROFIT OVER ANOTHER.


All of the candidates for Governor of Maryland will continue to work for this global corporate mess except CINDY WALSH FOR GOVERNOR OF MARYLAND.

I WILL REBUILD ALL WHITE COLLAR CRIMINAL AGENCIES IN MARYLAND AND SHOUT FOR THE FEDERAL JUSTICE AGENCIES TO DO THE SAME!

You know if US corporations are acting this fraudulently overseas.....and importing their products from overseas.....WE THE PEOPLE IN THE US ARE VICTIMS OF ABSOLUTELY NO OVERSIGHT!


Investing 7/29/2013 @ 4:13PM   Forbes

Is Big Pharma Addicted To Fraud?


Recent news out of China raises the question once again of whether any aspect of the pharmaceutical business can be trusted.

First, Chinese authorities announced they were investigating GlaxoSmithKline GSK +1.24% and other pharma companies for bribing doctors, hospitals and government officials to buy and prescribe their drugs. Glaxo is accused of using a Shanghai travel agency to funnel at least $489 million in bribes.

Then the New York Times revealed last week the alarming news that an internal Glaxo audit found serious problems with the way research was conducted at the company’s Shanghai research and development center.

Last year Glaxo paid $3 billion to resolve civil and criminal allegations of, among other things, marketing widely used prescription drugs for unapproved treatments and using kickbacks to promote sales.

And in 2009, Glaxo paid $750 million to resolve civil and criminal charges that quality failures led to serious contamination of drug products at its manufacturing operations in Puerto Rico.

Glaxo is a leader in pharma fraud and wrongdoing, with other industry heavyweights close behind. Over the past decade, whistleblowers and government investigations in the US have exposed a never-ending series of problems by numerous pharma companies in all facets of the industry, starting with fraudulent “research” papers used to bolster marketing and continuing through to the manufacture of contaminated and defective products, the marketing of drugs for unapproved and life-threatening uses and the mispricing of prescription drugs.

But the combination of pharma’s noncompliant corporate culture and the prevalence of corrupt business practices in China and other emerging economies could have a lethal impact on many more consumers as pharma shifts more research and development functions, manufacturing operations and marketing efforts to those growing markets.

In China, Glaxo allegedly used the travel agency to hand out inducements by claiming the payments were for travel and meeting expenses. Glaxo issued a statement by Abbas Hussain, Glaxo’s president international, that acknowledged some of its executives may have “acted outside of our processes and controls which breaches Chinese law.”

Chinese officials say they are investigating other foreign companies for similar charges. Merck & Co MRK -0.27%., Roche Holding and Sanofi SNY +1.31% SA confirm they used the same travel agency as Glaxo, but they haven’t been accused of wrongdoing.

Meanwhile, AstraZeneca AZN -0.86% — which previously reported that it is under investigation by the Securities and Exchange Commission and the Justice Department — said last week that police in Shanghai questioned two company sales managers, but “we have no reason to believe it is related to the other investigations.”

If the bribery accusations are true, the pharma companies could face charges in the US for violating the US Foreign Corrupt Practices Act, an anti-bribery law, as well as charges by Chinese authorities. Last year, Pfizer paid $60.2 million and Eli Lilly & Co. paid $29.4 million to the US to settle allegations they had bribed government officials, including hospital administrators and government doctors, in China and other countries to approve and prescribe their products.

But having to deal with a new cop on the bribery beat – China – should scare all pharma companies and their employees who have engaged in bribery. Four Chinese-born senior executives in China were originally detained, and last week Chinese media reported that police have detained 18 more Glaxo employees and some medical personnel. A British consultant to Glaxo in China also reportedly is being held. Chinese authorities may hold all of them in custody as long as the police feels it’s necessary – putting additional pressure on Glaxo and other pharma companies to resolve this matter.

Though Big Pharma’s practices in China are grabbing headlines, not much about them is truly new. Those tactics – the use of payments disguised as speaking and consulting fees, luxury travel, sex and numerous other inducements to expand sales of prescription drugs — are marketing techniques homegrown in the U.S.  They simply have been exported to emerging markets.

Now it’s China’s turn to express the same outrage that U.S. prosecutors did when faced with a recalcitrant industry that uses illegal inducements as a core business strategy for selling its prescription drugs.

“I need to remind foreign pharmaceutical companies that, because they occupy a leading position in the industry and reap huge amounts of commercial profits, they should also bear a great responsibility to society and the public,” Gao Feng, a Public Security Ministry official said at a July 15 briefing. “While we don’t expect them to set a moral example, we expect them to obey the law.”

That may be too much to expect from pharma, which has paid more than $30.2 billion in civil and criminal penalties to the US and state governments and continues to face more allegations of wrongdoing.

Big pharma’s woes in China underscore that the industry – despite huge penalties and a long string of public mea culpas – has a fraud habit that is just too profitable to kick. Finding a cure should be a top priority of regulators worldwide.

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As corporate NPR/APM was proud to state, no worries about fraud and penalties because these fines are so low that fraud settlements are simply worked into operational costs for US corporations now.  They are so low because neo-liberals in Congress and Maryland pass laws that cap awards and eliminate damage awards.  Remember, this is your Medicare Trust being eaten with fraud and then they tell you there are not enough funds in these Trusts.

NEO-LIBERALS IN CONGRESS AND MARYLAND WORK TO PASS LAWS THAT PROTECT CORPORATIONS FROM PUBLIC JUSTICE.

If you wonder why Maryland is never in the news for the same problems I describe across the country it is because Maryland does not have a public sector health department -----all has been privatized to non-profits like Johns Hopkins which in turn are the source of much of the malfeasance.  Add to that a captured media that does no investigations to hold power accountable and you have no news in Maryland.  Autocratic societies do not allow bad press to escape, only propaganda.

MARYLAND IS RANKED AT THE BOTTOM IN THE NATION FOR FRAUD, CORRUPTION, AND LACK OF TRANSPARENCY SO YOU KNOW THAT WHAT HAPPENS ACROSS AMERICA IS SOARING IN MARYLAND.

Below is just an isolated picture of what happens in specialties throughout health care.  It happens because there is no oversight and no public justice so all these health institutions assume they will get away with it.  It is fraud and profiteering that creates high costs in US health care and the Affordable Care Act does nothing for this.  Simply rebuilding oversight structures in Medicare and Medicaid cuts costs in half.  Why is Maryland not doing this??????

IF YOUR CANDIDATE IS NOT SHOUTING TO REBUILD RULE OF LAW IN YOUR STATE AND IN AMERICA----THEY ARE A NEO-LIBERAL WORKING FOR WEALTH AND PROFIT.


If you watch TV you are seeing more and more advertizing of trial lawyers and class action lawsuits for medical procedures, PHARMA, and devices placed onto market without proper clinical study using you and I as test subjects.  WHOOPS, THAT DIDN'T WORK THEY SAY.  Neo-liberal answer to this increasing legal environment------END CLASS ACTION LAWSUITS.


'Even the most jaded experts in fraud enforcement see a new level of callousness as some in the healthcare industry forget basic right and wrong in their quest for profits at any cost, including human suffering'.

Investing 9/12/2013 @ 4:36PM

Medicare Blood Money: The Healthcare Industry's Misalignment of Profits and Humane Medical Treatment Recent stories out of Chicago and Detroit give an unusually cruel meaning to “for-profit” medicine.

Authorities say a doctor at Sacred Heart Hospital in Chicago directed that his patients be heavily sedated, so that it was difficult for them to breathe. Then he would perform tracheotomies, cutting holes in their necks and windpipes, so they could breathe more easily.

The cost to Medicare for each tracheotomy: $160,000.

The cost to the patients – needless suffering. In some cases, death.

A Detroit oncologist is said to have administered unnecessary chemotherapy to patients who were in remission and ordered chemotherapy for end-of-life patients, rather than let the patients die in peace. The government said he even gave chemotherapy to people who didn’t have cancer. He allegedly made those treatment decisions simply to increase his Medicare payments.

Chemotherapy drugs are among the most toxic. Side effects from chemotherapy include nausea and vomiting, hair loss, diarrhea, extreme fatigue, swelling and pain.

Payments by Medicare to Michigan Hematology Oncology Clinics, the chain of clinics owned by the oncologist: $35 million over two years, $25 million of which was attributable to the oncologist, Dr. Farid Fata, according to the US Department of Justice.

The price patients paid: needless and extensive suffering up to their deaths.

In April, the government arrested the owner of Sacred Heart Hospital – where the tracheotomies were performed – as well as a senior executive at the hospital and four physicians affiliated with the hospital and charged them with conspiring to pay and receive illegal kickbacks in return for referring Medicare and Medicaid patients to the hospital. The Justice Department also said it was investigating alleged Medicare and Medicaid fraud schemes involving unnecessary sedation, intubation and tracheotomy procedures.

Meanwhile, the Detroit doctor, who entered a not guilty plea, is being held on $9 million bond.

These appalling allegations, if proven, remind us that Medicare fraud is not just about money; it often is about human life and dignity. It is blindingly obvious that no one should have to endure a tracheotomy, unnecessary intubation or chemotherapy unless it is absolutely necessary. Unfortunately, horrifying conduct by medical providers is not limited to individual physicians.

Big hospital chains (such as Tenet Healthcare ) have been accused of padding their bottom lines with money made from subjecting patients to unnecessary cardiology procedures. Big pharma has been known to sell vulnerable patients drugs contaminated with impurities, such as bacteria, glass and other substances (as happened with some GlaxoSmithKline and Ranbaxy Pharmaceuticals drugs). Medical device companies (most recently Johnson & Johnson ) continued to sell hip implant devices despite thousands of complaints about pain, metal debris from the devices and the need for additional surgery.

Even the most jaded experts in fraud enforcement see a new level of callousness as some in the healthcare industry forget basic right and wrong in their quest for profits at any cost, including human suffering.

An oncologist who worked for Dr. Fata told the FBI that he had been “living with this hell” by working for the Detroit doctor, according to the criminal complaint.

At least the doctor lived through his hell.  Unfortunately, the same can’t be said for many of these patients.
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Citizens of Maryland know neo-liberals are using Maryland as a model for opting out of the Federal Medicare program.  Johns Hopkins has partnered with Humana in their consolidation scheme and if you want to go to Hopkins for treatment you must join this insurer.  Humana is Medicare Advantage....a private Medicare insurer.  So, the system is being built such that a hospital can partner with insurers that will force you off of Federal programs and into private.  Do you really think the next step will not be to have these private Medicare plans in these state health systems?

THE ENTIRE AFFORDABLE CARE ACT CAME FROM THE SAME CONSERVATIVE THINK TANKS AS PAUL RYAN USES TO CREATE THE POLICY BELOW!!!!  THIS IS THE PLAN FOR ENDING MEDICARE.

As you see below Ryan's plan is what Maryland is moving to do now.  Neo-liberals and neo-cons will not leave any public asset or service in this race to send all wealth to the top. 

Do you really think Medicare and Medicaid Trusts are really going bust if trillions of dollars in entitlement fraud is recovered and future fraud and profiteering is stopped?  SHOUT OUT FOR NEO-LIBERALS TO STOP THE FRAUD.

Aug 2012 •


Paul Ryan's "Medicare Exchange"  

Paul Ryan is Romney's choice. Conservatives remember with glee how Ryan shredded Obamacare at the President's health care summit. Ryan said the bill was "full of smoke and mirrors." He looked right into the President's eyes. Six minutes later, Obama could barely respond.   Ryan's Medicare proposal now takes center stage. In March, Paul Ryan created shock waves with the Medicare reform proposed in his 2013 budget called "The Path to Prosperity."  His bold step changed the debate forever. Mr. Ryan's Medicare proposal "begins with a commitment to keep the promises made to those who now are in or near retirement. Consequently, for those 55 and older, the Medicare program and its benefits will remain as they are, without change." Thus he acknowledges the dependent situation of some of the elderly.    I'd like to report that Mr. Ryan, who brings all his Midwestern niceness into seemingly every encounter, proposes to completely obliterate Obamacare-like policies and give Americans a non-Medicare option in their sunset years. However, here are a few details:   First, I'm pleased to tell you that Ryan's plan repeals Obamacare (p. 94). But then his plan "would set up a carefully monitored exchange for Medicare plans" (p. 97), which would act much like the ACA's federal Exchange, with the government deciding which plans are available to seniors. He would also extend it to "non-retirees by giving certain employers the option to offer their employees a free choice option, smoothing the transition from their working years to when seniors become Medicare-eligible" (p. 97). This portends the possibility of the Medicare Exchange becoming a National Exchange.   Mr. Ryan's plan does move Medicare to a defined contribution program which he calls "premium support" (p. 96). However, it's not a voucher given to the individual, and just like the ACA, these government subsidies would be directly distributed to health plans through the Exchange (p. 97).    Also, like the ACA, a cap on the growth rate of spending would be implemented (p. 53). And finally, like the ACA, his plan includes "risk adjustment," which is done through profiling of patients. Higher payments go to health plans that enroll high-risk recipients (p. 219). Means-testing of seniors would also be required (p. 98), the age of eligibility would increase in 2023 (p. 97), and medical liability lawsuits would be limited (p. 98). Thus, Medicare would stay in place with various government intrusions and controls on choice, access and price.   Will Ryan's plan end Medicare as we know it? Medicare-as-we-know-it is already ending. The $38 trillion unfunded liability is three times the national debt, with bankruptcy possible as early as 2016. Medicare can't be saved in its present form. This is what scares politicians of all stripes who could soon be in the line of fire from 77 million babyboomers whose "retirement security" program is going bust.

  While Paul Ryan's current plan contains some troubling provisions and does not create a needed escape hatch for seniors, it does recognize the crisis ahead and begin the critical "What next?" discussion.

Please check my last blog under Social Security to see that neo-liberals are now building the structures to end Social Security as the Social Security and Medicare Trusts have been looted to build the Homeland Security/NSA network.  The American people have plenty of money----it simply needs Rule of Law reinstated and the fraud recovered.

IF YOU DO NOT HEAR YOUR INCUMBENT SHOUTING FOR JUSTICE FROM MASSIVE CORPORATE FRAUD.....IF THEY ARE PRETENDING AMERICANS ARE POOR......IF THEY ARE FIGHTING FOR UNEMPLOYMENT BENEFITS AND NOT THE HUNDREDS OF THOUSANDS OF DOLLARS EACH CITIZEN IS OWED FROM CORPORATE FRAUD-----THEY ARE WORKING FOR GLOBAL CORPORATIONS.  ALL MARYLAND POLS ARE GLOBAL CORPORATE POLS.

The next few days I want to look at the health care reform----Affordable Care Act.  By now people understand it is bad for the American people and has nothing to do with making health costs for citizens more affordable or increasing access to care for the poor.  That is just the progressive bones corporate neo-liberals throw when working for wealth and profit.  I want to look first at the mental health issue and how Medicare and Medicaid are continually under attack from fraud and corruption.  There is something more important than losing health coverage in the Affordable Care Act------there is the opening for yet more loss of civil liberties that take the US to autocratic policies of third world countries.  Again, it is being pushed under the guise of progressive bones and none of it is progressive.

EXPANDED AND IMPROVED MEDICARE FOR ALL IS THE ONLY SOLUTION TO HEALTH CARE COSTS AND QUALITY HEALTH CARE AND ACCESS FOR ALL!

Regarding the race for Governor of MD and health care reform:

In Maryland, citizens get an up-close look at what elections look like in third world countries. You have candidates running for governor with absolutely no administrative experience and two in the democratic primary, Brown and Gansler, with proven failures in office in administration on just a smaller scale. Cindy Walsh for Governor of Maryland has 3 decades of management/administrative experience and training on top of knowing more about the political issues of the day than my opponents who just repeat political talking points over and over.
So, the neo-liberal plan was to pass a republican health care policy getting all of its base mad and then fill the airwaves with propaganda on this issue that has no relevance to people's lives. Neo-liberals in Congress and Obama push a state run health insurance system with consolidation and deregulation and then VOILA----republicans have control of Congress and Hillary is elected and 'forced' to create the conditions for the predatory and profit-driven health systems to become Wall Street banks as she and Bill did their last terms. What? The Trans Pacific Trade Pact (TPP) has the US forcing public health all over the globe to end in order to maximize profits, drug costs soar because Bill Gates is now in the PHARMA business?

WELL, HILLARY WILL SIMPLY HAVE TO PUSH AND PASS TPP BECAUSE IT IS ALL THE REPUBLICANS FAULT.

This is the political scenario silenced by the constant talk of failed health system roll-outs. Doug Gansler has his face on buses telling the underserved communities he will fight for health insurance for the poor and yet, 1/2 of Medicare and Medicaid funding has been stolen under his watch as Maryland Attorney General. Anthony Brown is not worried about having no talent in administering public policy because the goal of this health care reform was setting up these private health systems that will end public health and send Medicare and Medicaid to states, ending these Federal programs. So, who cares as hundreds of millions of dollars are blown on roll-out-----the policies of health care privatization and ending entitlements is being installed under O'Malley/Brown. OPERATION SUCCESS SAY NEO-LIBERALS AND THEIR GLOBAL CORPORATE HANDLERS. His campaign ads have him FIGHTING FOR HEALTH JUSTICE at every turn. Let's look at the reality of this 'health justice' neo-liberals are planning for the citizens of Maryland.

First, let's look at mental health.....you know, the mantra of gun control pols pretending to be hard on policy and then not funding these policies they pretend to support. Mental health is a huge issue in America because since the Reagan/Clinton years this public sector has been defunded and is now a skeleton crew. Much of Medicaid spending goes to mental health and we know the entire system is full of fraud and corruption and people actually struggling with mental health issues almost always cannot get help. The system is set up to get mental health clients into a clinic with just enough time to give him/her medications to bill to Medicaid and then send them on their way with little followup. The current conditions having most of these people either failing to take medication, selling it, or having it stolen. That does not matter because the goal is MAXIMIZING PROFITS FOR PHARMA AND THE MORE THAT GOES OUT THE DOOR THE BETTER. Depression, bi-polar, and hyper-activity meds have our nation dosed out of what often is normal behavior.

I showed earlier that Bill Gates is now the owner of Prozac and many other mental health PHARMA soaring in profits from these policies. Abuse, fraud, and corruption drives these profits and it can all stop with rebuilding public oversight and accountability. These medications are not all bad it is just the way the system administers these mental health programs that make it a disaster for the Medicare/Medicaid Trusts, taxpayers, and these patient clients.

We know Affordable Care Act was written deliberately giving the health institutions the power to decide how to operate with less money from Medicare and Medicaid and the first thing that happens is these programs become worse and the emphasis on getting the drugs out the door increases.

INCREASE IN MASS SHOOTINGS TIED TO THE DISMANTLING OF THE MENTAL HEALTH SECTOR------YOU BETCHA!!!!!

THIS HEALTH REFORM ADDRESSING MENTAL HEALTH CRISIS------OH, REALLY??????

Features » April 1, 2014

The ACA Could Be the Death Knell for Chicago’s Public Mental Health Clinics

In 2012, Mayor Emanuel’s budget forced half the city’s public mental health clinics to close; now the remaining six are in danger, too.

BY Kari Lydersen

Mental health and labor advocates ... fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.

Thanks to the Affordable Care Act's expansion of Medicaid, many more Chicagoans will have access to mental health care in the near future. But ironically, the increased availability of health insurance could starve Chicago’s six remaining public mental health clinics of resources—and cause havoc for the city residents who depend on them.

In addition to serving those without insurance, the clinics have long provided care to locals with insurance who could have gone elsewhere, but saw the facilities as their most accessible and supportive option.

Over the past year, however, city officials reportedly started directing people with existing insurance to private or county mental health providers instead. And as formerly uninsured Chicagoans get new coverage from the Affordable Care Act, some say they, too, are being discouraged from attending the city clinics. While they theoretically could get care elsewhere, mental health advocates say that in reality, many are likely to fall through the cracks rather than moving to a provider they don’t trust.

Members of the grassroots coalition Mental Health Movement say that starting in 2013, public clinic staff members began pressuring uninsured clients to enroll in CountyCare, part of the state’s expanded Medicaid program. In turn, the clients say they’ve been told that once they have CountyCare or other insurance coverage, they will no longer be able to receive care at the public clinics.

A March 14 memo, obtained by In These Times and sent from Chicago Department of Public Health deputy commissioner Edie Bamberger, says that people with insurance and mental health needs “will be educated” about the “benefits of accessing integrated health care services through their insurance network,” which would not include the city clinics. If the client wants to attend a city clinic, the memo directs, public health staff should consult the clinic director; such requests will be considered on a case-by-case basis. People already attending a city clinic will be allowed to continue attending the clinic once they get insured, it continues, but the clinic director “must be made aware of this request.”

In other words, insured people who are already clients won’t be expressly prohibited from attending the city clinics, but staff are supposed to make an effort to divert them to other providers. And new insured clients won’t be expressly prohibited from the public clinics, but their attendance will have to be specifically approved. Previously, the DPH had a more strident ban on insured people obtaining services from the clinics; the shift in policy apparently came after the department faced a wave of criticism.

On April 2, aldermen who are part of the Chicago City Council’s Progressive Caucus will introduce a resolution calling for public hearings before the Council’s Health and Environmental Protection Committee on the state of mental health care in the city. At a press conference at City Hall on March 27, Aldermen Robert Fioretti and Scott Waguespack explained that the issue of whether and to what extent the public clinics will accept clients with insurance would be a central talking point at those hearings.

Chicago resident and Mental Health Movement member Horace Howard, who attended the press conference, says he has been receiving services from the public Greater Grand Boulevard clinic on the South Side since the Woodlawn clinic closed in 2012; he was part of the high-profile occupation at Woodlawn in April of that year. He claims that after several months going to Greater Grand, he still hasn’t been able to get an appointment with a doctor. (Clients at the public clinics typically meet with therapists on a regular basis and have less frequent meetings with psychiatrists.) But Howard still feels at home at the public clinics and doesn’t want to switch to another provider.

“We’re being kicked out because of managed care,” says Howard, 56, sporting a T-shirt bearing a portrait of Helen Morley, the Mental Health Movement member who died in 2012 of heart complications after famously telling Mayor Rahm Emanuel, “If you close my clinic, I will die.” Howard says the city should reopen the Woodlawn clinic “in memorial to Helen.”

Mental Health Movement member Ronald “Cowboy” Jackson says he knows several former clients of public clinics who were told since obtaining CountyCare coverage that they should go to the county hospital in Chicago instead. But people have had trouble getting appointments at the over-crowded county system, Jackson says; as a consequence, they have grown frustrated and stopped trying to get care.

Alderman Fioretti argues the changes to the system are only making it harder for Chicagoans in need. “They’re creating confusion out there,” he says. “For years, people have been going to these clinics. Now they’re being told they can’t … it’s adding more confusion, more disorientation for people in need of care.”

Because the Chicago Department of Public Health has so far not joined a healthcare provider network, including CountyCare, the public mental health clinics cannot be reimbursed under Medicaid as the state switches to managed care in coming weeks, meaning their funding will be put in danger. Just why the city hasn’t joined a network yet, however, remains unclear. (The department did not respond to an interview request for this story.) The March 14 memo claims that the department is encouraging insured people to go elsewhere because it “remains focused on preserving our limited capacity to serve uninsured residents with more limited options.”

A fact sheet handed out at the press conference rebuts that statement, though. It reads:

Turning away people with insurance means turning away money—revenue that could help strengthen the city clinics for everybody. Turning away that revenue will lower the number of people at the city clinics, lower the funding coming into them and likely end up causing more of them to close.

Mental health and labor advocates—including AFSCME, the union representing public clinic staff—fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect that reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.

“Once you have no one going to the clinic because they don’t accept insurance, then you can justify closing it because you have an empty building,” says N’Dana Carter, a leader of the Mental Health Movement.

Fioretti said that in closing and sidelining the clinics, Chicago’s leaders “throw our hands up and say we’re not going to do this service anymore.”

He and other aldermen have apologized for voting in 2011 for Mayor Emanuel’s 2012 budget, which closed six of the city’s 12 mental health clinics. “We made a big mistake,” he says.

Though Emanuel initially claimed the clinic’s closures would lead to an estimated $2.3 million in savings, Fioretti and his fellow progressive aldermen argue that this number “failed to account for the additional costs of increased emergency room visits, hospitalizations, police interventions and incarcerations.”

Alderman Waguespack says he has been disappointed by the city’s misplaced spending priorities. “You look at an $8 billion budget, and we can’t find $2.3 million?” he scoffs. “The city says we’re going to take away the safety net for such a small [savings]?”

Jackson, meanwhile, points to the mid-March standoff along Lake Shore Drive as an example of how unaddressed mental health crises can cause widespread trauma and cost taxpayers millions down the line. In that incident, a man with a history of mental illness who was suspected of killing his wife engaged police in an eight-hour showdown, closing off the major city thoroughfare along with nearby businesses.

“There’s a real effect on families and communities and schools” when people lack mental health care, Jackson says.

At a March 31 seminar on incarceration called “The $2 Billion Question” sponsored by the Chicago Community Trust and other groups, various speakers agreed that unavailable resources can have an enormously detrimental impact on individuals and their networks. They described, for instance, how a lack of mental health care can lead to the imprisonment of people who really need treatment, not punishment.

“We have a growing mentally ill population, both at the county and state level, that we’re struggling with how to deal with,” says Cook County Sheriff’s senior advisor Cara Smith.

At the seminar, she gave one example of the type of situations that land people with mental health issues in jail: A man grabbed a set of sheets or towels from a North Side Walgreens, walked out the door and told the clerk to “charge it.”

“$29.99 was the value of the item that he did not successfully steal,” Smith recounts. “And he was with us [in jail] for quite a long time … He had a very significant criminal history, mostly committing crimes of what I would call ‘survival’—criminal trespassing, retail theft—things to get shelter.”

“Because of the lack of services in the community, I can sit here and say many people are better off in the jail when they have severe mental illness because they’re getting care,” Smith continues. “Which is an awful thing to have to say.”

AFSCME is a website sponsor of In These Times. Sponsors have no role in editorial content.

Kari Lydersen

Kari Lydersen, an In These Times contributing editor, is a Chicago-based journalist and instructor who currently works at Northwestern University. Her work has appeared in the New York Times, the Washington Post, the Chicago Reader and The Progressive, among other publications. Her most recent book is Mayor 1%: Rahm Emanuel and the Rise of Chicago's 99 Percent. She is also the co-author of Shoot an Iraqi: Art, Life and Resistance Under the Gun and the author of Revolt on Goose Island: The Chicago Factory Takeover, and What it Says About the Economic Crisis. Look for an updated reissue of Revolt on Goose Island in 2014. In 2011, she was awarded a Studs Terkel Community Media Award for her work. She can be reached at kari.lydersen@gmail.com.
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Keep in mind that the federal government and states gutted Medicaid funding these few years to pay for the massive corporate fraud of tens of trillions of dollars. So, when your pol acts as though they are adding funding to mental health after this huge gutting of funds-----THEY ARE LYING TO YOU! What is surfacing is a huge attack on all civil liberties and a further move towards totalitarianism. Can you imagine a government having the ability to force people to take drugs they do not want in the confines of their homes because the entire public health system with group living situations are being dismantled?

IT IS CRAZY AND YOUR NEO-LIBERAL IS MOVING THAT WAY EVEN IF THEY ARE NOT OPENLY SUPPORTING THIS BECAUSE WHEN PEOPLE ARE LEFT WITH ONLY HOME CARE AND LAWS ARE BROAD FOR THESE KINDS OF TREATMENTS THERE WILL BE ABUSE AND YOUR POLS KNOW THIS.

Remember, the problem with mass shootings by people with severe mental illness is that these people cannot access the kind of care and facilities they need to control these illnesses. We can effectively treat these diseases but that costs money and neo-liberals and neo-cons do not see any money coming for public services and programs. So, they easiest solution------forced medication with home care people overseeing what are catatonic conditions. Think of conditions for mental health institutions without proper oversight and then place individuals in their homes with only national chains providing barely trained home care employees. THIS IS DICKENSIAN.

I will add that US citizens are being assaulted by police acting outside of Constitutional policing -----imagine these officers having the power to determine people's mental health status. We are already going to jail because police are using illegal tactics for jailing protesters and killing citizens. Police need to remain out of the diagnostic loop for mental illness.

HAVE YOU SEEN PEOPLE PLACED ON THESE SCHIZO PHARMA? THEY ARE OFTEN CATATONIC AND HELPLESS.

Why are we reforming our mental health guidelines written at a time when all people had civil rights and liberties when the problem was funding and access to quality care?

'And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups'.

Mental Health Groups Split on Bill to Overhaul Care

By BENEDICT CAREY  APRIL 2, 2014

Lawmakers, patient advocates and the millions of Americans living with a psychiatric diagnosis agree that the nation’s mental health care system is broken, and on Thursday, Congress will hear testimony on the most ambitious overhaul plan in decades, a bill that has already stirred longstanding divisions in mental health circles.

The prospects for the bill, proposed by Representative Tim Murphy, Republican of Pennsylvania, are uncertain, experts say, given partisanship in both the House and the Senate and the sheer complexity of the mental health system. And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups.

But the bill, the Helping Families in Mental Health Crisis Act, does have more than a dozen Democratic co-sponsors in the House, and several mental health organizations are supporting it. Last week, both houses of Congress adopted one of its central provisions, expanding funding for outpatient treatment programs through other legislation. On Thursday, the House Energy and Commerce health subcommittee is scheduled to hear testimony on the entire bill, which includes more than two dozen measures.

“It’s the most comprehensive mental health bill we’ve seen in a long, long time, and that in itself is an accomplishment,” said Keris Myrick, chief executive of the Project Return Peer Support Network and president of the board of the National Alliance on Mental Illness, which supports some parts of the bill. “I think almost everyone sees things in the bill that are long overdue, but also things they’re very concerned about.”

Among those opposing the bill because of its involuntary treatment provisions is the Bazelon Center for Mental Health Law, whose president, Robert Bernstein, said, “Many serious organizations seem to have an ‘any port in the storm’ mentality, supporting this bill even though it includes dangerous provisions.”

Mr. Murphy, a clinical psychologist from Pittsburgh, put together the legislation at the behest of House Republican leaders after the massacre at Sandy Hook Elementary School in Newtown, Conn., in 2012. He spent a year hearing testimony about the current system, a patchwork of community clinics and state hospitals chronically short of funding that leaves millions of people with mental illness without treatment, often homeless or in prison.

“It’s a broken system, and we’re not going to fix it by throwing a little money here or there,” Mr. Murphy said in an interview. “We know that when people get care, they get better, but there are simply not many options: Clinics are reducing services, there are not enough psychiatrists or psychologists to go around — we found all sorts of barriers to care.”

Widely backed provisions of the bill include streamlining payment for services under the Medicaid program, and providing funds for clinics that meet standards for rigorous, scientifically supported care.

The bill also provides money for suicide prevention programs and for so-called telepsychiatry, or remote video therapy, which is seen as especially crucial in rural areas.

Provisions calling for increased training for police officers and emergency medical workers in how to identify and treat people with mental disorders are also widely approved. The police and paramedics often act as ad hoc social workers, dealing with people with mental problems when they are hurt or break the law.

About 350,000 Americans with a diagnosis of a severe mental illness like schizophrenia or bipolar disorder are in state jails and prisons, while the number of psychiatric beds available has shrunk to 35,000, according to a coming analysis by the Treatment Advocacy Center, a nonprofit group that favors expanded access to treatment.

“The situation has been getting progressively worse for 50 years, to the point where we now have 10 times more people with severe mental illness in prisons and jails than in mental hospitals,” said Dr. E. Fuller Torrey, of the Stanley Medical Research Institute, a nonprofit organization supporting research in schizophrenia and bipolar disorder, and a strong supporter of the bill.

But the bill’s backing for involuntary treatment is highly contentious. It would provide state grants for so-called assisted outpatient treatment programs under which certain mentally ill people with a history of legal or other problems get court-ordered therapy, which in most cases means trying to ensure they take their medication.

The result: more people treated earlier, and more treated against their will.

“This becomes a civil rights issue quickly, and it can drive people away from seeking services when they fear treatment will be forced on them or they’ll be locked up,” said Gina Nikkel, president and chief executive of the Foundation for Excellence in Mental Health Care, which advocates a more holistic, less medication-oriented approach to recovery.

In the last two decades, 45 states have adopted laws allowing compelled treatment in some cases, with varying requirements and levels of enforcement. Kendra’s Law, passed in New York in 1999, is one that researchers have monitored closely. One recent analysis, led by investigators at Duke University, found that since the law was passed, patients were much less likely to land back in the hospital or be arrested. Mental health and Medicaid costs for them dropped by about half.

But involuntary treatment programs have led thousands of former psychiatric patients to become fierce critics of the mental health system.

Dr. Bernstein of the Bazelon Center and Dr. Nikkel said that extending such programs would “eviscerate civil right protections” and further erode trust between patient and provider.

The Murphy bill also proposes amending federal medical privacy protections — the now-familiar Hipaa laws — to allow parents or other caregivers access to a patient’s medical information. Under current law, those records are private once a person becomes an adult, and as a result, caregivers are often effectively cut out of treatment decisions. The bill seeks to bring them back in, with a provision that will also generate strong political resistance, experts said.

Finally, the bill proposes to sharply scale back many of the programs funded by the Substance Abuse and Mental Health Services Administration. This agency, with a $3.6 billion budget, has long financed programs that critics say are not backed by good evidence.

“When something has been funded for a long time, it’s tough to let it go,” Mr. Murphy said. “What we’re saying is that if a program works, then show us the evidence that it does, and we’ll keep it. If the evidence is not there, then the taxpayers shouldn’t pay for it.”

______________________________________________

Citizens of Maryland have a front seat to neo-conservative public policy because much of public policy pushed by Maryland neo-liberals is written by Johns Hopkins----the most neo-conservative institution in the world. You can see why Maryland has no democratic party when they all work for Johns Hopkins. Maryland's gun control policy mirrors this mental health policy-----it writes law that looks at mental illness very broadly making it possible to take gun ownership rights away for the most common of mental health issues. Now, gun control advocates may think this is good----but it will be used to end people's civil liberties and this extends to mental health diagnosis and treatment.

When everyone knows the problem with gun violence has little to do with mental health issues needing new laws.....why are are we allowing a government controlled by neo-liberals and neo-cons write laws at a time of NSA and totalitarianian suspension of Rule of Law and mass fraud and corruption. The worst of totalitarian regimes use these issues to throw people into jail and losing our public justice and Bill of Rights set this tone.

MARYLAND IS IN THE CATEGORY OF DEFUNDING AND DISMANTLING ALL PUBLIC HEALTH WHILE TRYING TO PASS LAW THAT TAKES CIVIL RIGHTS AWAY. THIS IS VERY, VERY, VERY BAD.

In Gun Debate, a Misguided Focus on Mental Illness

By RICHARD A. FRIEDMAN, M.D.
Published: December 17, 2012

In the wake of the terrible shooting at an elementary school in Newtown, Conn., national attention has turned again to the complex links between violence, mental illness and gun control.

The gunman, Adam Lanza, 20, has been described as a loner who was intelligent and socially awkward. And while no official diagnosis has been made public, armchair diagnosticians have been quick to assert that keeping guns from getting into the hands of people with mental illness would help solve the problem of gun homicides.

Arguing against stricter gun-control measures, Representative Mike Rogers, Republican of Michigan and a former F.B.I. agent, said, “What the more realistic discussion is, ‘How do we target people with mental illness who use firearms?’ ”

Robert A. Levy, chairman of the Cato Institute, told The New York Times: “To reduce the risk of multivictim violence, we would be better advised to focus on early detection and treatment of mental illness.”

But there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.

This does not mean that mental illness is not a risk factor for violence. It is, but the risk is actually small. Only certain serious psychiatric illnesses are linked to an increased risk of violence.

One of the largest studies, the National Institute of Mental Health’s Epidemiologic Catchment Area study, which followed nearly 18,000 subjects, found that the lifetime prevalence of violence among people with serious mental illness — like schizophrenia and bipolar disorder — was 16 percent, compared with 7 percent among people without any mental disorder. Anxiety disorders, in contrast, do not seem to increase the risk at all.

Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. In the National Institute of Mental Health’s E.C.A. study, for example, people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.

It’s possible that preventing people with schizophrenia, bipolar disorder and other serious mental illnesses from getting guns might decrease the risk of mass killings. Even the Supreme Court, which in 2008 strongly affirmed a broad right to bear arms, at the same time endorsed prohibitions on gun ownership “by felons and the mentally ill.”

But mass killings are very rare events, and because people with mental illness contribute so little to overall violence, these measures would have little impact on everyday firearm-related killings. Consider that between 2001 and 2010, there were nearly 120,000 gun-related homicides, according to the National Center for Health Statistics. Few were perpetrated by people with mental illness.

Perhaps more significant, we are not very good at predicting who is likely to be dangerous in the future. According to Dr. Michael Stone, professor of clinical psychiatry at Columbia and an expert on mass murderers, “Most of these killers are young men who are not floridly psychotic. They tend to be paranoid loners who hold a grudge and are full of rage.”

Even though we know from large-scale epidemiologic studies like the E.C.A. study that a young psychotic male who is intoxicated with alcohol and has a history of involuntary commitment is at a high risk of violence, most individuals who fit this profile are harmless.

Jeffrey Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.”

It would be even harder to predict a mass shooting, Dr. Swanson said, “You can profile the perpetrators after the fact and you’ll get a description of troubled young men, which also matches the description of thousands of other troubled young men who would never do something like this.”

Even if clinicians could predict violence perfectly, keeping guns from people with mental illness is easier said than done. Nearly five years after Congress enacted the National Instant Criminal Background Check System, only about half of the states have submitted more than a tiny proportion of their mental health records.

How effective are laws that prohibit people with mental illness from obtaining guns? According to Dr. Swanson’s recent research, these measures may prevent some violent crime. But, he added, “there are a lot of people who are undeterred by these laws.”

Adam Lanza was prohibited from purchasing a gun, because he was too young. Yet he managed to get his hands on guns — his mother’s — anyway. If we really want to stop young men like him from becoming mass murderers, and prevent the small amount of violence attributable to mental illness, we should invest our resources in better screening for, and treatment of, psychiatric illness in young people.

All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group. But the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.

How the TPP Would Impact Public Health
How the Trans-Pacific Partnership
exposethetpp.org

IF YOU ARE NOT READING INTO THESE POLICIES THE VISION OF SANITARIUMS FROM THE DAYS OF CHARLES DICKENS------YOU DO NOT UNDERSTAND HEALTH CARE REFORM WRITTEN BY HEDGE FUNDS...THE AFFORDABLE CARE ACT.

THIS IS A LONG BLOG.....PLEASE GLANCE THROUGH ALL ARTICLES!

Regarding corporate commentators Fraser Smith and Basu on private non-profits and health care reform in Maryland:

FRASER SMITH AND BASU HIT IT ON THE HEAD.....JOHNS HOPKINS UNIVERSITY CREATED THE PRIVATE NON-PROFIT MARYLAND HEALTHCARE FOR ALL TO CAPTURE THE POLICY ISSUE OF UNIVERSAL CARE AND MADE SURE IT WENT WITH AFFORDABLE CARE ACT-----PRIVATIZATION FOR PROFIT AT THE EXPENSE OF ACCESS TO HEALTH CARE-------AND SO THE POLICY WOULD NOT GO TOWARDS EXPANDED AND IMPROVED MEDICARE FOR ALL, THE REAL UNIVERSAL CARE POLICY.

So, a corporation created its own private non-profit to push it own policy agenda using taxpayer money and private donations to make sure policy went towards maximizing profit for Johns Hopkins. That is indeed what this proliferation of corporate private non-profits is about.

SO, WHAT ABOUT THIS LADY FRASER MADE TO SOUND THANKFUL TO HAVE THIRD WORLD HEALTH CARE WITH TODAY'S MEDICAID AFTER LOSING A FIRST WORLD QUALITY HEALTH PLAN?

We hear time and again that this Affordable Care Health Reform is a Republican idea pulled together first by Reagan and implemented by Romney in Massachusetts. It is indeed a Republican plan. Affordable Care does not mean affordable for people, it means affordable for corporations and profit-maximizing.....Third Way corporate neo-liberals in Mass passed this plan just as they are now in Maryland. What we are seeing is the requirement to have health insurance partnered with health access that is window-dressing. When Massachusetts says it has almost universal coverage it isn't telling you that the coverage that many people have is just the preventative public health level we are seeing hitting Maryland. Who are those falling into this Medicaid level care? The article below written in 2010 looks at immigrant and low-income care but makes clear that the window is opening as to who will receive this level of care.

Massachusetts health care plan “dangerously restricts access” to primary care

Published August 9th, 2010 iHealthBulletin News!

The first health care plan from a for-profit insurance company approved to offer government-subsidized coverage under Massachusetts’ health care reform has dangerously restricted access to primary care, according to data reported on August 5, 2010 in the New England Journal of Medicine. Researchers say the findings raise troubling concerns about the Obama administration’s new health law, which is modeled after the Massachusetts plan.

Three Harvard-affiliated physicians report that out of a list of 326 doctors identified as members of the provider network of CeltiCare, a for-profit insurer contracted by the state of Massachusetts to take over coverage of about 30,000 legal immigrants (and, more recently, low-income citizens), only 217 were non-duplicate adult primary care providers. Of these 217 doctors, 25 percent could not be reached by telephone.

Of those primary care doctors who were reachable by telephone, only 37 percent, or 60 providers, said they were accepting new CeltiCare patients. In those cases, the average wait time for an appointment was 33 days, even though the patient was described as having a chronic illness like diabetes or hypertension.

Moreover, although many of the patients who had been forced into the CeltiCare plan don’t speak English, only 38 of the doctors who were accepting new patients had any form of translation services.

The plan’s failure to provide adequate access to doctors for its members raises grave concerns not only about Massachusetts’ reform, but also about the recently enacted national reform, the researchers say. The national plan closely mirrors Massachusetts’ reform, but relies far more heavily on for-profit insurers.

The report points out that even when patients have insurance, profit-driven plans may discourage them from getting the care they need by “rationing by inconvenience.”

The data appears in a letter titled “Immigrants’ experience with publicly funded private health insurance” in the August 5, 2010 print edition of the journal. It was written by two resident physicians at the Harvard-affiliated Cambridge Health Alliance and a Harvard Medical School faculty adviser, and is based on the work of a group of interns, residents and medical students from several Boston-area hospitals and medical schools.

These doctors-in-training carried out the research after they became worried when some of their sickest patients – patients with cancer, diabetes and other severe health problems – were forced from their existing insurance plan into the CeltiCare plan. They then were told that they could no longer be treated at many of their previous health clinics, forcing them to find new doctors.

The researchers identified doctors available to the CeltiCare patients using the plan’s “Find a Provider” website. They called each of the doctors’ offices within a 5-mile radius of their hospital, identifying themselves as relatives of a chronically ill, older adult who needed an appointment soon. If an appointment was offered, the researcher asked about the availability of translators.

“Trying to get an appointment was even more daunting than these numbers suggest,” said Dr. Cassie Frank, a co-author of the article. “Many clinics forced me to call several times to get an appointment. One said they only open up appointments on Monday morning, and that to have a chance of getting any appointment slot I’d have to show up an hour before the clinic opened to be first in line.”

Dr. Malgorzata Dawiskiba, another co-author, said: “The state suddenly shifted thousands of sick patients to a cut-rate plan. But instead of getting a bargain, the patients were left stranded – insured, but unable to find a doctor who could care for them. These were people whom we knew. We and our supervisors had been their doctors, sometimes for many years, and overnight they were told ‘you can’t come here anymore.’”

Dr. Ruth Hertzman-Miller, an instructor at Harvard Medical School and study co-author, commented: “The problems faced by CeltiCare’s patients may soon become much more widespread. Our legislative leaders want to require every insurer in Massachusetts to offer a plan with a restricted list of doctors and a lower price tag. But that kind of restricted coverage may be little more than a worthless piece of paper” (Courtesy of Eurekalert).

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What we are seeing in Maryland already is an inability of low-income people or inadequately insured people to get the normal treatment for common diseases. When you have to co-pay a $100,000 treatment, how does that affect your future access? YOU WON'T HAVE ANY. Baby boomers are told they will not be affected, but at age 55 I know that when I start having major health issues in a decade or so, all of this reform will not protect my Medicare coverage.

OTHER COUNTRIES DO UNIVERSAL CARE WITH SATISFACTORY SERVICE......DO YOU HEAR THE ENGLISH, CANADIAN, OR FRENCH SHOUTING OUT AGAINST THEIR HEALTH SYSTEMS? DO YOU HEAR OF THE POOR CLIMBING INTO THE BACKS OF VANS FOR HEALTH CARE WHILE THE RICH HAVE HEALTH BOUTIQUES IN THESE COUNTRIES?

VOTE YOUR NEO-LIBERAL INCUMBENT OUT OF OFFICE!!

Making all of health care about profit moves drugs to market-based operations.  So, if a drug is not used much it will be made expensive or will not be manufactured.  We already are seeing shortfalls in availability of common drugs because of market-based health policy.  IT WILL GET WORSE IF LEFT TO CONTINUE.

No Health Insurance Dims Cancer Fate Cancer Outcomes Worse for People With No Health Insurance or Inadequate Health Insurance

By Miranda Hitti
WebMD Health News Reviewed by Louise Chang, MD

Dec. 20, 2007 -- Cancer patients without adequate health insurance tend to face grimmer odds than those with good health insurance, says the American Cancer Society.

The American Cancer Society today released a new report on health insurance and cancer.

The report shows that people with no health insurance or inadequate health insurance face four main challenges when it comes to cancer:

They're less likely to get screened for cancer.
They're less likely to get counseled about cancer prevention.
They're more likely to get diagnosed late, when their cancer is harder to treat.
They're more likely to die from cancer than people with adequate health insurance.

Take breast cancer, for instance. The report shows that women with private health insurance are more likely to get mammograms, get diagnosed earlier, and have better survival rates than uninsured women.

The same is true for colorectal cancer. The report shows that among adults aged 50-65, about half of those with private health insurance had gotten screened for colorectal cancer in the past decade, compared with almost 40% of those with Medicaid insurance and about 19% of uninsured people.

Noting that some new cancer treatments cost more than $100,000 per year, the American Cancer Society's report asks, "To what extent will availability and type of insurance coverage, as well as individual financial resources, determine who has access to the most effective therapies?"

Health insurance isn't the only gap in cancer care. Racial and ethnic disparities also affect cancer outcomes.

The American Cancer Society based its report on information from the CDC and from the National Cancer Data Base.

The findings appear in CA: A Cancer Journal for Clinicians.
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CHECK OUT THE DESCRIPTIONS OF THESE HEALTH HOMES THEY PLAN FOR MEDICAID/MEDICARE PEOPLE. THEY ARE SIMPLY COMPOUNDS OF CARE WE ALREADY KNOW WILL BE RUN BY HUGE HEDGE FUND-SIZED CORPORATIONS THAT HAVE NO INTENTION BUILDING A CARING/QUALITY ENVIRONMENT.

What is the difference between the retirement communities and state nursing homes we have today and what ACA is calling community-centered health homes? First, retirement communities and state nursing homes were run by private non-profits like religious communities and the government having the public's interest at heart. What ACA if creating is a national system of corporate businesses often owned by hedge funds and run with only thoughts of profit and raiding entitlement Trusts with fraud. We already had the kinds of facilities ACA is creating only they were not structured for profit.

THINK HOW A HEDGE FUND WILL OPERATE A COMMUNITY HEALTH HOME.

Community homes for seniors and the poor with chronic health conditions.....sound a little like the sanitariums of hundreds of years ago? YOU BETCHA!!!!! Think who will age or fall into poverty in this downward spiral of neo-liberalism------ALMOST EVERYONE. HOW MEDIEVAL OF NEO-LIBERALS!!!



MEDICAL HOMES-----for the poor that means isolated health care focusing on containing communicable diseases and mental health issues. It is third world speak for containing disease vectors as cheaply as possible. As I mention above, the old practice of SANITARIUMS is the model. It will become a Dickens' nightmare as public health is dismantled and no public oversight allows a level of neglect we do not want to allow.

You notice that ACA sends billions of dollars to fund the building of these structures and this is happening as more and more people lose private health insurance or public health plans are getting ready to be thrown into these state health systems relegating most people to the status of Medicaid.

SEE WHY NEO-LIBERALS ARE PUSHING EXPANDED MEDICAID RATHER THAN FIGHTING TO RECOVER TRILLIONS OF DOLLARS LOST FROM ENTITLEMENT TRUSTS FROM CORPORATE FRAUD.

We simply need to rebuild white collar criminal agencies and stop the massive fleecing of Medicare and Medicaid, recover funds lost to fraud, and we will be flush with money to fund a first world quality of health care for all.


HMMMMMMM.....MEDICAL ENTERPRISE ZONES SEEM TO BE THE FEDERAL MONEY BUILDING THIS SYSTEM

Community-Centered Health Homes

Community-Centered Health Homes Bridging the gap between health services and community prevention ...practices, including the patient-centered medical home,

aswww.ravenswoodfhc.org/images/pdf/community-centered...

Transforming Community Health Centers into Patient-Centered Medical Homes: The Role of Payment Reform

September 28, 2011

Authors: Leighton Ku, Ph.D., M.P.H., Peter Shin, Ph.D., M.P.H., Emily Jones, M.P.P., Brian Bruen, M.S.
Contact: Leighton Ku, Ph.D., M.P.H., Director, Center for Health Policy Research in the Department of Health Policy, George Washington University leighton.ku@gwumc.edu
Editor: Deborah Lorber

"FQHCs have long sought to provide quality team-based, comprehensive primary care and typically viewed themselves as serving as medical homes, even before there were formal definitions for medical homes."

Overview This report examines how changes in the way federally qualified health centers (FQHCs) are financed could support the transformation of these critical safety-net providers into high performing patient-centered medical homes. Through surveys and interviews, the authors explore the current landscape of health center involvement in medical home initiatives, adoption of medical home standards, and receipt of payment incentives. Based on their findings, the authors make preliminary recommendations to encourage health centers to serve as patient- and community-centered medical homes. These include: establishing recommended standards for patient- and community-centered medical homes that apply to FQHCs; structuring payment incentives to promote medical homes; including FQHCs in state Medicaid medical or health home projects; adapting payment approaches, including adding monthly case management fees; and encouraging the Health Resources and Services Administration to use quality-of-care measures in making funding decisions.

Executive Summary

The Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) significantly altered the landscape of American health care policy. In addition to expanding coverage to millions of uninsured and increasing funding to expand community health centers, the Affordable Care Act initiates efforts to change how health care is paid for and delivered in the United States. For example, the law encourages state Medicaid programs to develop medical homes, also known as "health homes," for Medicaid patients with chronic diseases. More broadly, the law calls on federal and state governments to consider other methods to transform health care delivery, including strategies such as creating accountable care organizations and bundling episodes of care. The large increases in the number of people with health insurance, including Medicaid patients, after the implementation of health reform will require the nation and the states to consider strategies to strengthen primary care services as part of a high performance health system.

This report examines how changes in the way federally qualified health centers are financed could support the transformation of these critical safety-net providers into high performing patient-centered medical homes. Federally qualified health centers (FQHCs), also known as community health centers or clinics, are nonprofit facilities that provide comprehensive primary medical care—and often dental, vision, and behavioral health services—to low-income patients in medically underserved areas, regardless of a person's ability to pay.

In late 2009, we conducted a survey of state primary care associations, which represent community health centers in their states. We followed up this survey with interviews of selected health center, state agency, and managed care staff about medical home and quality initiatives in their states. In the majority of states, health centers receive payments to serve as primary care providers or medical homes, generally under Medicaid, and more recently have begun to serve as patient-centered medical homes. There was great diversity in the nature of medical home programs, medical home criteria, and stages of development. In some cases, private physicians are eligible for medical home payments, but health centers are not.

FQHCs have long sought to provide quality team-based, comprehensive primary care and typically viewed themselves as serving as medical homes, even before there were formal definitions for medical homes. Nonetheless, many FQHCs have demonstrated interest in attaining formal recognition as a medical home.

Preliminary data from a George Washington University survey of FQHCs, conducted from 2010 to 2011, indicate that about 6 percent of centers have attained National Committee for Quality Assurance–Patient Centered Medical Home (NCQA–PCMH) recognition, another 12 percent have a pending application, and 40 percent expect to seek recognition in the next 18 months. Some (12%) have received or applied for recognition from a state medical home program and 11 percent are considering another national recognition program. One reason some centers do not consider applying is there is no financial reward for attaining recognition, as some states do not have medical home incentive programs for FQHCs.

We present several financing recommendations to increase the incentives for FQHCs to transform themselves into high-performing medical homes:

Establish recommended standards for patient- and community-centered medical homes that apply to FQHCs. A variety of national and state recognition programs exist for medical or health homes, but they generally focus only on patient-centered medical care. Health centers also seek to provide community-centered services, such as offering access to patients regardless of ability to pay; providing nonmedical services like behavioral, dental, or enabling services (like case management, health education, and translation); and conducting community needs assessments and other prevention-oriented projects. It may be relevant to establish standards that emphasize these broader community-oriented service components.
States should include FQHCs in Medicaid health home projects. Under the Affordable Care Act, state Medicaid programs may establish health home projects for those with chronic health conditions. In the past, some state medical home programs excluded FQHCs because they are paid differently than physician practices. Since FQHCs provide primary care to a substantial and growing number of Medicaid patients, they should be included in all state Medicaid health home projects.
Clarify that states may pay FQHCs more than the levels prescribed by the prospective payment system. Although federal Medicaid policy that governs health center payments does not prevent states from paying FQHCs more than the prospective payment system (PPS) level, which is based on historical Medicaid costs and then updated, some states appear to interpret the statute as constituting a cap on FQHC payment levels.
If states adopt medical or health home incentives, providing monthly case management fees per Medicaid patient is a reasonable approach. States considering this option could add a monthly medical home case management fee, in addition to regular FQHC reimbursements, as an appropriate way to create a payment incentive for medical home status. This is already used in many states and is the method planned for the Medicare FQHC Advanced Primary Care Practice demonstration project.
Clarify how states may increase FQHC payment levels under Medicaid. Under current federal rules, states may change PPS payments to individual health centers when the centers demonstrate a change in the scope of Medicaid services. However, there is no specific provision for changing the PPS
payments when a health center increases the quality or intensity of services it provides.
Maintain the all-inclusive per-visit payment rates in Medicaid. Under federal law, Medicaid payments to FQHCs are paid on a flat, all-inclusive, per-visit (or per encounter) basis. To change the system would require substantially changing all FQHC payment rates, which would take years to develop. Given current state budget problems, in which state Medicaid programs have often trimmed provider payment rates, opening all FQHC payment rates to recalculation could place them at substantial risk of unanticipated reductions.
The Centers for Medicare and Medicaid Services (CMS) should ensure that Medicare policies are consistent with medical home goals. CMS has announced two Medicare advanced primary care medical home demonstration projects, one for FQHCs and one that permits multipayer projects in several states. CMS should continue to develop these projects. CMS is also actively developing policies in related areas, such as those related to Medicare accountable care organizations, and should ensure that the objectives of those policies are ultimately supportive of medical home policies as well.
The Health Resources and Services Administration has long encouraged quality of care for FQHCs and supports Section 330 grantees as NCQA–PCMHs, but could consider additional efforts. The Health Resources and Services Administration (HRSA) seeks to build on the already strong quality of care delivered by health centers by focusing on quality improvements and ways that payment reforms could affect health centers. HRSA provides grants to subsidize the cost of NCQA–PCHM applications for FQHCs that receive federal Section 330 grants. In allocating funds to grantees, HRSA has not traditionally used quality of care in funding decisions. HRSA is improving information collected about the quality of care at Section 330 grantees under its Uniform Data System. In the future, HRSA could develop incentives to improve the quality of care at health centers or performance as medical homes. It could develop further efforts to help integrate health center coordination in medical home, health home, and advanced primary care projects, working with Medicare, Medicaid, and the Children's Health Insurance Program—and eventually the health insurance exchanges.

As the concept of a medical home and other paradigms to strengthen the health care infrastructure are implemented, FQHCs will serve as laboratories for innovation to test new care models. Adequate and appropriately structured financial incentives are critical to the success of any model of health care delivery, and the medical home is no exception. In addition to changes to the reimbursement system that would better align incentives, other supports for providers such as training and technical assistance are necessary to bolster and support the infrastructure.
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This is what happens when health care becomes about maximizing profits. Staff are not always to blame. People are being sent to do jobs for which they are not prepared. Standardization of care misses lots of individual symptoms and history. Having hedge funds operating medical care can only be a spiraling disaster for health care. SHOUT FOR EXPANDED AND IMPROVED MEDICARE FOR ALL.

This article is a good look at what has happened as health care moves from hospital to nursing facilities, but it doesn't address the gorilla in the room------home health care skilled and non-skilled. If you know nursing homes and community care facilities are rife with bad care you know this booming national health chains of home health care businesses are really, really bad. THEY ARE. This is what all of these private for-profit career job training schools are releasing on the public and it is not pretty. The students graduating are not at fault most times....they are being steered into programs that do not prepare them for the jobs they will do and these health businesses for which they are hired are not monitored or operating legally in many cases.

THIS IS WHAT ACA DOES IN TANDEM WITH PRIVATIZATION OF EDUCATION....IT DEVELOPS A SYSTEM WHERE EDUCATION FEEDS BUSINESSES AND IT IS ALL PROFIT-DRIVEN.

So, Americans are being told they will be serviced at home at the same time academics are seeing the lowest quality of training for students entering these fields. I want to qualify that home health care businesses have been around for decades and many offer strong, quality care and staffing. What we are seeing from ACA is a flooding of the market with national chains simply there to make a buck anyway they can. This article below has a Hopkins professional reporting these shortfalls as Baltimore is ground zero in the worst health care in these kinds of facilities and Hopkins is public health in Baltimore. It's like interviewing the fox about how best to stop foxes from raiding the hen house.

DO YOU SEE HEDGE FUNDS AND GLOBAL CORPORATIONS RISING TO THE CALL TO IMPROVE QUALITY OF CARE?

'About 40 percent of people over age 65 will spend time in a nursing home at some point, Mollot said. Hopefully, he said, the inspector general’s report will help the public see that care needs to improve'.

He said,

“They are dangerous, dangerous places”.


Keep in mind with this article below that in Maryland, where Medicare is being dismantled by privatization with no Federal oversight, has the goal to end all Federal oversight of Medicare. 1/2 of Medicare spending is lost to fraud and you see Federal spending by Medicare is sent to building these skilled nursing businesses. When the Federal Medicare program is privatized to these state systems, there will be no public oversight as described in this article.

One Third of Skilled Nursing Patients Harmed in Treatment

March 16th, 2014

Special Report from ProPublica

by Marshall Allen, ProPublica

One-in-three patients in skilled nursing facilities suffered a medication error, infection or some other type of harm related to their treatment, according to a government report released recently that underscores the widespread nature of the country’s patient harm problem.

Follow up:

Doctors who reviewed the patients’ records determined that 59 percent of the errors and injuries were preventable. More than half of those harmed had to be readmitted to the hospital at an estimated cost of $208 million for the month studied — about 2 percent of Medicare’s total inpatient spending.

Patient safety experts told ProPublica they were alarmed because the frequency of people harmed under skilled nursing care exceeds that of hospitals, where medical errors receive the most attention.

Dr. Marty Makary, a physician at Johns Hopkins Medicine in Baltimore who researches health care quality, said -

“(The report) tells us what many of us have suspected ­­– there are vast areas of health care where the field of patient safety has not matured”.

The study by the inspector general of the U.S. Department of Health and Human Services (HHS) focused on skilled nursing care – treatment in nursing homes for up to 35 days after a patient was discharged from an acute care hospital. Doctors working with the inspector general’s office reviewed medical records of 653 randomly selected Medicare patients from more than 600 facilities.

The doctors found that 22 percent of patients suffered events that caused lasting harm, and another 11 percent were temporarily harmed. In 1.5 percent of cases the patient died because of poor care, the report said. Though many who died had multiple illnesses, they had been expected to survive.

The injuries and deaths were caused by substandard treatment, inadequate monitoring, delays or the failure to provide needed care, the study found. The deaths involved problems such as preventable blood clots, fluid imbalances, excessive bleeding from blood-thinning medications and kidney failure.

One patient suffered an undiagnosed lung collapse because caregivers failed to recognize symptoms. The patient later had a reaction to medication and a blood clot and had to be transferred to a hospital.

Projected nationally, the study estimated that 21,777 patients were harmed and 1,538 died due to substandard skilled nursing care during August 2011, the month for which records were sampled.

Medicare patients “deserve better,” said Sen. Bill Nelson, D-Fla., chairman of the U.S. Senate Special Committee on Aging. Nelson said he would push for better inspections of the facilities. He said,

“This report paints a troubling picture of the care that’s being provided in some of our nation’s nursing homes”.

The report said it is possible to reduce the number of patients being harmed. It calls on the federal Agency for Healthcare Research and Quality and the Centers for Medicare & Medicaid Services (CMS) to promote patient safety efforts in nursing homes as they have done in hospitals.

The authors also suggest that CMS instruct the state agencies that inspect nursing homes to review what they are doing to identify and reduce adverse events.

In its response to the report, CMS agreed with the findings and noted that the Affordable Care Act requires nursing homes to develop Quality Assurance and Performance Improvement programs. The agency’s quality improvement work includes a website for nursing homes that was launched in 2013.

A “skilled nursing” facility provides specialized care and rehabilitation services to patients following a hospital stay of three days or more. There are more than 15,000 skilled nursing facilities nationwide, and about 90 percent of them are also certified as nursing homes, which provide longer-term care.

As hospitals have moved to shorten patient stays, skilled nursing care has grown dramatically. Medicare spending on skilled nursing facilities more than doubled to $26 billion between 2000 and 2010. About one-in-five Medicare patients who were hospitalized in 2011 spent time in a skilled nursing facility.

John Sheridan, a member of the American College of Health Care Administrators, which represents nursing home executives, called the report valuable but noted that it sampled only a small number of patients. He questioned whether the findings apply broadly to skilled nursing facilities.

Sheridan also strongly disagreed with the report’s observation that there’s less known about patient safety in skilled nursing facilities compared to hospitals. He said Medicare has robust inspections of nursing homes it certifies – they take place annually or when there are complaints and are usually conducted by state contractors. Medicare also keeps detailed data on the violations, he said. (ProPublica’s Nursing Home Inspect makes it easy to search and view Medicare inspection reports.)

Sheridan agreed that skilled nursing facilities could improve, but said the caregivers face a daunting task and work diligently despite low reimbursements Medicare pays to the facilities.

Sheridan said of the providers that -

“They don’t go to work every day to cause an adverse event. They do it to care for the residents there. They do it with sacrifice and love.”

Dr. Jonathan Evans, president of the American Medical Directors Association, a group focused on nursing home care, said while he doesn’t dispute the estimates in the inspector general’s report, they are typical of problems that exist throughout the health care sector.

Evans said that patients receiving skilled nursing care are leaving hospitals sooner and that many are not medically stable and have more intensive needs. Nursing homes, originally designed for long-term patients who did not need intensive care, and have been slow to adapt, Evans added.

He said,

“You have a system of long-term care that’s trying to retrofit to be a system for post-acute care. The resources to care for them and commitment from those sending them from one facility to another haven’t kept pace.”

Evans called the study significant and said he hopes it raises awareness and sparks improvements.

Makary, the Johns Hopkins’ doctor, said the patient safety movement has been more focused on problems at hospitals than in nursing homes.

A 2010 report by the HHS inspector general estimated that 180,000 patients a year die from bad hospital care, and other estimates have been higher. The patient safety research community has focused on reducing bloodstream infections and surgical errors at hospitals but has done less to address issues specific to nursing homes, Makary said.

Developing metrics to track improvement would be more effective than annual inspections, which don’t do a good job of capturing a facility’s everyday performance, Makary said.

Patient advocates said the study verifies what they’ve heard from skilled nursing patients and their families. Richard Mollot, executive director of New York’s Long Term Care Community Coalition, said he was “flabbergasted” by medication errors, bedsores and falls that were identified in the report.

They are prominent problems that nursing homes should be “well versed” to address, he said.

Mollot said the report should have more forcefully called for better enforcement of the existing standards in nursing homes.

States inspect nursing homes on behalf of Medicare every year and when there are complaints, he said, but some inspectors are tougher than others. Medicare’s current standards of care are good, he said, and “if they were enforced we wouldn’t have these widespread problems.”

About 40 percent of people over age 65 will spend time in a nursing home at some point, Mollot said. Hopefully, he said, the inspector general’s report will help the public see that care needs to improve.

He said,

“They are dangerous, dangerous places”.
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This article show too where things will go in the US if neo-liberals remain in charge. Spain has been taken by the worst of TROIKA politicians and the public sector is being gutted and a strong public health care system and quality wages and staffing dismantled. Remember, Trans Pacific Trade Pact (TPP) and its Atlantic Trade deal pushes the dismantling of public health all over the world so US private health systems will maximize profits. Here is a former first world country moving to third world in one fell swoop. This is the goal of TPP---to take formerly first world nations to the level of developing countries under the guise of needing to be competitive globally.

THAT'S A NEO-LIBERAL FOR YOU----ALL MARYLAND POLS ARE NEO-LIBERALS!

Outrage as nurses are appointed at less than €4 per hour

by TPN/ Lusa, in News · 05-07-2012

Portugal’s national nurses register publicly announced on Monday that it considered it “scandalous” for nursing professionals to be placed on contracts earning less than four euros per hour and appealed for those who could “not to accept” the proposals.
Outrage as nurses are appointed at less than €4 per hour

This is a scandal for Portugal, for a first world country, that is offering highly qualified professionals at a price per hour that is incompatible with their profession and their dignity," said Germano Couto from the national nurses register Ordem dos Enfermeiros, adding that he had received "a series of denunciations" from "tens of nurses who have contracts at €3.96 per hour."

Mr. Couto spoke in reaction to news published in Diário de Noticias that nurses hired by temping agencies for the health centres of Lisbon and the Tagus Valley region who started work on Monday will receive less than four euros per hour.

He guaranteed that the news piece "is real" and "there are facts and evidence", although he added that he hoped it "isn’t more than a series of intentions" and so "may be reverted by the Lisbon and Tagus Valley regional health authority and the Ministry of Health."

Mr. Couto added that the government may be "paying more to these companies" for them to "obtain their profit" but highlighted that it is necessary to check whether these companies are fulfilling the contract conditions, as the €3.96 per hour the nurses will earn equates to €300 in their pockets at the end of the month, which doesn’t even qualify as minimum wage.

Currently, the average wage deemed acceptable for nurses in Portugal is around €1,020 per month, which is around seven euros per hour and that value "should be the yardstick the government should use."

Following the news of the reduced wages for new nursing contracts in the Lisbon area, the national nurses register has "appealed to nurses not to accept these contracts if they are able," adding that they do however understand if some go ahead "so as not to lose their status."

Mr. Couto considers that many health professionals prefer to move abroad rather than end up unemployed or lose their status, criticising that Portugal is "training nurses for export" at a time when there is need in the country.

In response to the news, the Lisbon and the Tagus Valley health authority (ARSLVT) announced that the nursing contracts were put to tender at prices per hour varying between €4.77 and €5.19 and declined any responsibility of wages being paid below four euros per hour.

The price per hour "results from the public tender whereby the companies involved presented their proposals," ARSLVT said in a statement.

The health authority said it had launched a public tender for the acquisition of nurses with a base value of €8.50 per hour, which corresponds to the average price on the market for this type of service.

"The values presented by firms that responded to the public tender were substantially lower than the base value, and all those 50 percent below it were excluded from the public tender because of the legal reason that they were abnormally low values," said the statement.

ARSLVT added that "the majority of firms presented values much reduced compared to that proposed by ARSLVT, with a price being fixed between €4.77 and €5.19" in the end.

"Negotiation of salaries and conditions is the exclusive responsibility of the firms that responded to the public tender and their staff," the regional health authority concluded.

New Push for Single Payer Healthcare for All

The cause of universal healthcare is alive and well. Not only is the state of Vermont moving toward a single-payer system, but Vermont's U.S. Senator Bernie Sanders has introduced a bill and is holding a hearing this week on the benefits other countries enjoy from a single-payer system that would benefit everyone except the profiteering middlemen who've rigged the current system.

ALL OF MARYLAND'S CANDIDATES FOR GOVERNOR WILL CONTINUE THIS AFFORDABLE CARE ACT PRIVATIZATION OF PUBLIC HEALTH-----CINDY WALSH SUPPORTS EXPANDED AND IMPROVED MEDICARE FOR ALL!

As citizens of Maryland listen to the failures of implementing its private health insurance system WE THE PEOPLE have decided to move forward with Expanded and Improved Medicare for All.  Neo-liberals think they can simply run as progressives in elections and then implement republican policies that end all public programs and services but citizens have figured out this game.

Privatizing public health with Affordable Care Act is more than losing access to basic health procedures and care.  It is about losing our public health agencies structured to oversee the data collected on the health of the nation, the agencies that hold the health industry accountable for quality and malpractice, and the agencies tasked with public justice in regards to health outcomes.  In other words, it creates the same conditions of deregulation that gave us Wall Street banks and their unaccountability.  In addition to preying on people for profits, the public will not know that the data provided in approving medical products and techniques are true and if what is being given as treatment is dangerous.  The public now faces a litany of drugs hitting the market that have not gone through clinical trial and the practice of using the general public as the source of knowledge of medical efficacy for products is becoming more common.  If you have universities as corporations that patent research you have lost pure academic study that provides facts in public interest.  If you lose your public health agencies that provide data collection that is honest, you lose your ability to hold health industries accountable.

THIS IS HUGE FOLKS!  DISMANTLING PUBLIC HEALTH WILL HAVE ALL CITIZENS DISTRUSTING HEALTH PROFESSIONALS AS WE DISTRUST OUR BANKS!

Below you see where this is going.  Payers are health insurance agencies and providers are the doctors and hospitals.  This article shows the intent to end public health data collection and analysis in overseeing the health care industry from research, to hospital care, to outcomes.

Remember, the Centers for Medicare and Medicaid have decades of public health data stored in its database that show all of the information needed to assess the cost benefit of procedures, the outcomes from procedures, the average prices paid for every procedure.  WE ALREADY HAVE ALL OF THE DATA NEEDED TO DEVELOP A MEANINGFUL APPROACH FOR COST EFFECTIVE HEALTH CARE.  What neo-liberals are doing is handing all of the development of cost models to the very people creating the inflated costs by health fraud and profiteering.  This article says------we do not need public funding of data exchanges because with public funding comes public oversight and transparency.  Can you imagine corporations paying for the data collection for medical procedures and products they develop?


The Affordable Care Act is about ending public health and deregulating the health industry just as Clinton did the banking industry.  It ends all public ability to oversee, to hold accountable, and to collect data that can be reliably used to protect public interest.  Maximizing profits means corporations will write the policies that end public health.



Payers, Providers Question Value of Public Health Data Exchanges

Tuesday, January 28, 2014 TOPIC ALERT:

• Health Data Exchange

Click on topic to receive periodic emails. The majority of payers and providers believe that the business model of publicly funded health information exchanges is flawed, according to a Black Book survey, Health Data Management reports.

Survey Details, Findings For the survey, Black Book polled 1,550 providers and 794 payers.

According to the survey, 95% of payers, 83% of hospitals and 70% of physicians said HIEs funded by federal grants have flawed business models and do not assist with meaningful connectivity (Goedert, Health Data Management, 1/27).

In addition, 94% of surveyed payers said they did not see "value proposition" in public HIEs (Sullivan, Government Health IT, 1/27).

Less than 33% of surveyed providers said they participate in public HIEs, while 86% said they have rejected paying the annual fees for public HIEs (Health Data Management, 1/27).

More than 80% of the 220 operating public HIEs in the U.S. are stalling as federal grants supporting many of those HIEs ends, according to Government Health IT (Government Health IT, 1/27).

Seventy-two percent of survey respondents predict that there may be only 10 public HIEs left after federal grant money for them expires in 2017.

More than 80% of respondents concluded that a national operational public HIE is more than a decade away (Walsh, Clinical Innovation & Technology, 1/28).

Meanwhile, the report also found that many payers have been investing more heavily in private HIEs, rather than public exchanges.

Doug Brown, managing partner of Black Book, said, "Payers are looking for [return on investment] that the majority of public HIEs aren't even close to delivering, [s]o it was inevitable the private HIE market got so hot" (Government Health IT, 1/27).
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Here in Baltimore, all of public health has and is being privatized to private corporate non-profits that write health policy, that implement all that policy in communities, and that are the source of all data that comes to the public.  All is done under the restrictions of the public to transparency protections given private non-profits.  We have little access as the public to any of the policy-writing, any of the use of Federal and State funding on behalf of health services, any sense of oversight of the data being presented to the public on the state of public health.

We know that Medicare and Medicaid fraud is rampant and as much as 1/2 of spending on entitlements are lost to fraud.  This in turn affects the health programs implemented and it affects the result data we receive. 

RAISE YOUR HAND IF YOU UNDERSTAND THAT CORPORATIONS PROVIDING A SERVICE WILL HAVE THE INCENTIVE TO SKEW DATA TOWARDS THEIR BENEFIT AND NOT THE PUBLIC INTEREST?  THAT IS WHY THE US HAS A PUBLIC SECTOR-----TO SERVE THE PUBLIC INTEREST.

Neo-liberals work in the corporate interest and push these policies of privatization so that corporations have all the control.



What Is the Public Health System?

The public health system once was thought of as comprising only official government public health agencies, but now is understood to include both other public-sector agencies (such as schools, Medicaid and environmental protection agencies, and land-use agencies) and private-sector organizations whose actions have significant consequences for the health of the public. The public health system includes the following four main components:

• Mission – The mission of the public health system includes its goals at any point in time and how, at the conceptual level, these goals are operationalized. At the beginning of the 21st century, the mission of public health is to ensure conditions in which people can be healthy.2
• Structure – The structural capacity of the public health system is the cumulative resources and relationships necessary to carry out the important processes of public health. Structural capacity includes the following elements: information resources, organizational resources, physical resources, human resources, and fiscal resources. 2
• Process – The practice of public health can be thought of in terms of the key processes through which practitioners seek to identify, address, and prioritize community or population-wide health problems and resources and the outputs of these more fundamental processes, public health’s interventions, policies, regulations, programs, and services.The processes of public health are those that identify and address health problems as well as the programs and services consistent with mandates and community priorities. 2
• Outcome – The immediate and long-term changes experienced by individuals, families, communities, providers, and populations are the system’s outcomes, the cumulative result of the interaction of the public health system’s structural capacity and processes, given the macro context and the system’s mission and purpose. Outcomes can be used to provide information about the system’s overall performance, including its efficiency, effectiveness, and ability to achieve equity between populations.
  _______________________________________
  
  If you look at the leaked documents for the Trans Pacific Trade Pact you will see it involves ending public subsidy of health and indeed, Obama Administration is actively lobbying nations around the world to end generous public health subsidy as part of these trade deals.  NEO-LIBERALS ARE TRYING TO FORCE NATIONS AROUND THE WORLD TO END PUBLIC HEALTH AND THEY ARE DOING THAT IN THE US WITH THE AFFORDABLE CARE ACT.
  
  Building state health systems is a republican policy to end Federal public health programs.  They have tried for decades to do this and it is Obama and neo-liberals passing the laws to do it.  They want as much as republicans to downsize the public sector and health care is the largest sector left to privatize.  Private health systems are designed to give the health industry control of writing all of the policies in this reform and they are writing them to the industry's benefit and to the public detriment.
  
  
  
  

• 
  FOR IMMEDIATE RELEASE
  July 24, 2013
  4:27 PM
  
  CONTACT: US PIRG
  
  Phone: (202) 546-9707
  
  Congress Mulls Dismantling America’s Public Health and Consumer Protections WASHINGTON - July 24 - “The Regulatory Accountability Act (H.R. XX) and the Regulatory Flexibility and Improvement Act (H.R. 2542)  would threaten the health and safety of the American people, by disarming standards like the ones that keep children safe from faulty cribs and toxic toys. These bills would block enforcement of critical laws by creating new bureaucratic hurdles and impossibly short timelines for approval of public health rules.
  
  “The Regulatory Accountability Act would add layers of new bureaucratic processes before even simple public health rules could be enforced, and empower special interests to use the courts to delay protections that have been years in the making.   For example, in 2011 after a 10 year fight, Congress authorized and the Consumer Product Safety Commission developed new safe crib standards.  Parents finally received protection against collapsing cribs that injured and killed far too many infants. The RAA Act would make it easier for special interests to contest the new crib standards in court, delaying these critical protections.
  
  “The Regulatory Flexibility Improvements Act, by adding new layers of red tape and bureaucracy,will potentially jeopardize straightforward proposals. This could hurt the ability to create important new tools such as the www.SaferProducts.gov website, which provides parents with information on dangerous and toxic toys and children’s products.
  
  “As a nation, we have made significant progress toward ensuring a safe and healthy marketplace for consumers.  Congress should continue in that proud tradition and oppose these bills, to protect the health and safety of the American people.”
  
  ________________________________
  Below you see a democratic state struggling with simple public health issues that ACA force into the reform category.  It is not only republican states that will use this move to state control of health policy-----neo-liberal states are dismantling services under the guise of lack of state budget for public health.
  
  Below you see policy that looks a lot like the policies working to implode the US Post Office.  Regulations that hit public health hardest will force the public sector out of business and private sector simply absorbs the cost until it takes control of once public sector services.  Look at what conservative states are doing to Planned Parenthood to end abortions.  The use of targeted regulations makes the cost to public health too expensive just to put them out of business.
  
  If you talk with doctors in the public health field they will tell you that decades of massive entitlement fraud pushed the need to commit fraud to stay in business onto public health agencies. 
  
  WE WATCHED AS THESE SAME PRACTICES BLEW UP OUR PUBLIC HOUSING AGENCY AND OUR PUBLIC EDUCATION AGENCY.  THEY ARE NOW COMING FOR PUBLIC HEALTH.
  


• REMEMBER, THE US HAS THE HIGHEST COST IN HEALTH CARE BECAUSE OF MASSIVE FRAUD AND CORRUPTION IN THE INDUSTRY-----NOT BECAUSE PATIENT COSTS ARE HIGH.  GOVERNMENT COFFERS ARE EMPTY BECAUSE CORPORATIONS ARE PAYING NO TAXES.  THESE ARE THE PROBLEMS.  NEO-LIBERALS ARE MAKING THE PUBLIC PAY THE SHORTFALLS.
  
  
  

• 
  New CDC Regulations Threaten to Dismantle Vaccines for Children Program
  
  The policy changes would affect how providers store and replenish vaccines and have a severe impact on rural clinicians. Jeff McDonaldSignificant federal policy changes could force many providers to opt out of Oregon’s well-established immunization program, potentially leaving kids around the state unvaccinated and with a higher risk of disease, state health care leaders and providers say.
  
  New policies from the Centers for Disease Control and Prevention (CDC), set to take effect as early as Feb. 1, could dismantle the state’s successful Vaccines for Children (VFC) program, which includes about 600 clinics and serves about 52 percent of the state’s children in the state.
  
  Among the new requirements is the separation of public and private inventory with public stock including VFC and state purchased vaccines. Public stock includes VFC and state-funded Children's Health Insurance Program (CHIP) doses, while the state’s Billable Project provides immunizations to children with private insurance.
  
  “The purpose of this requirement is to assure VFC vaccine is not administered to non-VFC eligible children,” wrote Melinda Wharton, CDC’s deputy director, in a Sept. 5 memo. “This has been identified through various program integrity reviews as a critical risk. For this reason, we must require that VFC vaccine be stored separately in providers’ offices.”
  
  CDC has introduced the policy changes in response to an audit of the federal VFC program by the Office of Inspector General, which found unacceptable accounting and vaccine storage and handling practices in several states around the country.
  
  Oregon was not among those states cited in the audit and has already found a way to work around a portion of the CDC’s policy changes for the Advance Credit Model, which took effect Oct. 1.
  
  Last week, the Oregon Health Authority (OHA) announced it would pay up to $7.5 million in advance for the cost of vaccines for both CHIP and Billable programs. Those costs have been in arrears quarterly by the state under the old model after the CDC had provided the vaccines in advance.
  
  But other parts of the new regulations could prove more onerous and lead to private clinics dropping out of the VFC program, said Mimi Luther, VFC manager with the Oregon Health Authority’s Public Health Division.
  
  “The risk is that we will have kids who don’t have access to vaccines,” she said.
  
  Oregon’s VFC program, which started as part of a federal program in 1995, relies upon a system of provider accountability for waste and a vaccine tracking method that is one of the most established in the country, Luther said.
  
  The new policies, which have been in flux since they were announced in August, would change how providers store and replenish vaccines and ultimately lead to lower vaccination rates and greater vulnerability in an outbreak, Luther said.
  
  Under the current regulations, when providers run out of doses marked for VFC kids, they can borrow from their supply of Billable doses and replenish the supply through reordering. Roughly 43 percent of providers borrow vaccines that are intended for different eligibility groups or from other providers, she said.
  
  That practice would no longer be allowed under the new regulations.
  
  One exception to this rule would occur in times of outbreak, but would require providers to get written permission from the state’s Public Health Officer, who would need written permission from the CDC, Luther said.
  
  “That is just absurd,” she said. “Can you imagine being a pediatrician during an outbreak and saying, ‘sorry, I can’t immunize your kid today? It is crazy.”
  
  Storage guidelines also would change, potentially costing up to thousands of dollars for larger clinics.
  
  Another new requirement is that providers organize and stock their vaccines in separate refrigeration bins for different eligibility classes, including VFC, CHIP, Billables, and Section 317 clients, according to OHA. Many providers would need to purchase new refrigerators and increase their staffing and electricity costs to meet those requirements.
  
  Additionally, the new regulations would dismantle the state’s successful buying program, which requires providers to pay for any doses that are wasted or expired.
  
  “Oregon always has required providers to pay for waste because we think it’s a good stewardship of public dollars,” Luther said.
  
  The system has proven successful with only a 2 percent rate of waste, she said.
  
  But under new CDC regulations, providers would be required to buy replacement doses on the private market.
  
  The costs would increase dramatically in most cases.
  
  Using the state’s bulk buying power, the cost of a single dose of measles, mumps and rubella (MMR) vaccine would cost $19.75 through the state and $56.14 through the private market.
  
  “The state has huge purchasing power and contracts in place,” she said. “What I pay for a vaccine is much less than anybody would pay for on the private market.”
  
  Exemplifying this point, Luther priced Hepatitis A vaccine at $15.25 for a single dose from the state and $30.40 on the private market. Polio vaccine would cost $12.42 and $27.44, respectively.
  
  That is ordering a single dose. Most private insurers sell vaccines in packs of 10, so while an HPV vaccine would cost $107.16 from the state, a provider would end up paying about $1,350 from private insurers for a 10-pack, according to Luther.
  
  “I am hopeful that Oregon is going to find a way to not require the separate inventories,” Luther said. “I am sure in my heart that if we fail at that we are going to lose many providers.”
  
  The new policy guidelines could have the most impact on rural clinicians, who would need to follow a new set of storage and handling guidelines that would increase costs and potentially leave some clinics short of vaccines at critical times.
  
  “They’re trying to fix something that isn’t broken in our state,” said Michael Sheets, a family nurse practitioner and owner of The Merrill Clinic and The Bonanza Clinic in rural Southern Oregon. “Potentially what could happen is that some of the centers may opt not to do immunizations instead of meeting these requirements.”
  
  The value of the VFC program in rural areas cannot be overstated, said Sheets, who drives 23 miles between his two private clinics and spends a half-day at each.
  
  The private clinics fill in a 96-mile stretch between the Public Health Department in Klamath Falls and the next closest public facility in Lakeview.
  
  “Basically, we’re not making any money on this,” Sheets said. “Providers are trying to help the kids because otherwise the working poor couldn’t afford to get their shots.”
  
  At his two clinics, Sheets administers a variety of shots for kids in the VFC and CHIP programs, including influenza, chicken pox, diphtheria and polio.
  
  Since the program began in the mid-1990s, ear, sinus and respiratory infections have dropped dramatically because of the shots, he said.
  
  “The kids that have these shots, don’t end up having those problems,” he said. “The value cannot be overstated in terms of reduced illness. It is a marriage of the public and private sector that works. We should have more of that, not less.”
  
  Vaccines are currently stored and marked according to eligibility classes in a single refrigerator unit close to exam rooms, Sheets said. Under the proposed CDC rules, providers could end up needing additional storage space and temperature monitoring equipment to meet the CDC regulations, he said.
  
  Additional refrigeration unit in each of his clinics would cost $400 to $500. The units would need to be moved further away from the patients due to lack of space, he said.
  
  Clinicians could opt out of the system altogether, forcing rural families to travel further distances to get to the closest clinic, Sheets said. Or patients could potentially be turned away, he said.
  
  “The new regulations are not in the best interests of anyone,” he said. “Somebody who is sitting in Atlanta or D.C. has written the regulations and doesn’t know how clinics work.”
  
  The next steps for Oregon’s medical community include asking CDC for an exemption to the new requirements or a delay in their implementation until December, 2014, OHA’s Luther said.
  
  The state would like the opportunity to problem solve the new regulations with the CDC, she said.
  
  Otherwise, the changes would shift the burden onto already cash-strapped county health departments, said Karen Vian, immunization program manager for Douglas County Public Health.
  
  Vian is one of many members of the health community who have shared their story with the state, and her experiences could help shape national policy, Luther said.
  
  “These policy changes don’t work for the private sector and they don’t work for the public sector,” Vian said. “Public health departments are going to be unable to meet these policy changes.”
  
  
  _______________________________________

The Affordable Care Act seeks savings for Medicare and Medicaid by requiring the use of generic drugs.  Yet, as we see below, the US is pushing policies that make it harder to create generics and limit generic sales.  So, how do you think that will ultimately effect seniors and the poor in the US?

That's right.  People already have cases where the generic form of a drug is not as effective so if TPP passes this will grow in frequency.

• The TPP’s Threats to Public Health


• The Trans-Pacific Partnership (TPP) is an international trade and investment pact currently under negotiation between the United States, Australia, Brunei Darussalam, Canada, Chile, Malaysia, Mexico, New Zealand, Peru, Singapore and Vietnam. It is also specifically intended as a “docking agreement”that other countries would join over time, with Japan, Korea, China and others already expressing some interest. U.S. negotiators are pushing to complete the TPP as soon as possible.NEGOTIATIONS ARE HEADED IN THE WRONG DIRECTION ON PUBLIC HEALTH  A roll back from the Bush administration.Leaked U.S. proposals for several chapters in the Trans-Pacific Partnership reveal that U.S. trade negotiators have reversed hard-won reforms designed to enhance access to affordable medicines that were made during the George W. Bush administration. In addition to pushing for increased monopoly rights for drug companies, the U.S. is also demanding new rights for pharmaceutical firms to challenge pricing and other drug formulary policies used by many countries to keep down health care costs.PACT WOULD REDUCE ACCESS TO GENERIC MEDICATION BY EXTENDING DRUG PATENTS
  Access to generic medicine is critical to saving lives. The first generation of HIV drugs has come down in price from roughly $10,000 per patient per year to just $120 thanks to increased access to generic medications. This reduction in price has helped to dramatically scale up the number of people throughout the world who are now receiving treatment. The Global Fund to Fight AIDS, Tuberculosis and Malaria, the President’s Emergency Plan for AIDS Relief, UNITAID and UNICEF all rely heavily on access to quality generic medications. For millions of people throughout the globe, delaying access to generic medications means delaying access to treatment. The U.S. proposal would grant new monopoly patent rights, reducing access to generic medicine. If finalized and implemented, the leaked U.S. intellectual property proposal would roll back access to generic medicine for people in developing countries and throughout the world. Specifically, the U.S. proposal would broaden the scope of patentability by making it easier for pharmaceutical companies to patent new uses and minor variations of old medicines; slow the production of new generics when patents expire by expanding “data exclusivity” over clinical trials forcing either the timely and costly replication of such trials or an additional three-year delay (beyond the current five) before such “exclusivity” ends;constrict safeguards against patent abuse by makingit harder for public health advocates to challenge unjustified new patents; require new forms of drug patent policing;and mandate that countries allow patents on plants, animals Trade Policy & Access to Medicine!


• _____________________________________
  
  
  What neo-liberals intend to do as they privatize public health goes beyond actual access to health care.  The public sector is the last labor unions holding on to middle-class income and as we already see with handing health policy-writing to states developing private health systems as in Maryland------it is staff and labor costs cut under the guise of making health care cost effective.  Women are the ones being hit by this attack on the public sector with public private partnerships and the ending of public health.
  
  DO YOU HEAR NEO-LIBERALS SHOUTING THEY ARE THE PROTECTORS OF WOMEN, CHILDREN, AND THE MIDDLE-CLASS?  DO YOU SEE THE STATE OF MARYLAND ADOPTING ALL THAT IS PRIVATIZATION OF PUBLIC SERVICES, PROGRAMS, AND ASSETS?
  
  MARYLAND ADOPTED A STATE PRIVATE HEALTH SYSTEM BECAUSE IT IS RUN BY NEO-LIBERAL POLITICIANS WORKING FOR JOHNS HOPKINS AND THE HEALTH INDUSTRY!
  
  

• Roosevelt House Faculty Forum
  Triple Jeopardy: Dismantling of the Public Sector and the War on Women
  
  Mimi Abramovitz Bertha Capen Reynolds Professor of Social Policy at the Silberman School of Social Work at Hunter College, and a Roosevelt House Faculty Associate; Faculty of the CUNY Graduate Center and the Murphy Institute for Worker Education and Labor Studies. Posted on January 13, 2014
  
  The current effort to dismantle the public sector is the latest round in the rancorous debate about the role of so-called “big government” that has shaped public policy since the mid-1970s. There has been much buzz in recent news surrounding the widening inequality gap, the long-term effectiveness of President Johnson’s Great Society programs in combating poverty, and President Obama’s call to increase the federal minimum wage.  While these issues are extremely important, it has been surprising to see the lack of a gender lens in these dialogues, a perspective that is absolutely critical in evaluating potential policy changes.
  
  Since the onset of the economic crisis in the mid-1970s, U.S. leaders have pursued a neoliberal agenda designed to downsize the government, and redistribute income upwards. Its familiar tactics include tax cuts, retrenchment, privatization, and deregulation, among others.  To win public support for these unpopular ideas, neoliberal advocates have resorted to what Naomi Klein called the “shock doctrine”: the creation and manipulation of a crisis to impose policies that the public would not otherwise stand for. Discounting evidence and evoking the shock doctrine, government foes targeted programs for the poor but also popular entitlement programs—once regarded as the “third rail” of politics. Unlikely to pass Congress intact their proposals which fall heavily on women –will set the agenda for months to come.
  
  The current effort to dismantle the public sector is the latest round in the rancorous debate about the role of so-called “big government” that has shaped public policy since the mid-1970s. Initially targeted at program users, the attack subsequently took aim at public sector employees and union members. Since most scholars and activists focus on one group or another, they miss the strategy’s wider impact. Lacking the gender lens needed to bring women into view, they also miss that women comprise the majority in each group. Until the 2012 presidential campaign turned the women’s vote into a hot political issue, few officials paid much attention to women’s issues or did much to end the decades-long “war on women”
  
  Given that women make up the majority of government service users, employees and union members, the cuts constitute a “war on women.” Many of the programs now on the chopping block address the basic needs of women and their families over the life span. Current House budgets proposed to to cut child care, Head Start, job training, Pell Grants, housing, and more by $1.2 trillion over the next 10 years.
  
  Less spending by Washington translates into reduced federal aid to states and cities. To balance their budgets, states spent $75 billion less in 2012 than in 2011, and 31 states projected a $55 billion shortfall in state budgets for the 2012 fiscal year.  In total, states governments have had to close more than $540 billion in shortfalls over the past four years due to cutbacks on the federal level.  In addition, the right has taken aim on women’s reproductive health services, demanding ever more drastic cutbacks.  In 2012, The Guttmacher Institute reported that legislators in 46 states introduced 944 provisions to limit women’s reproductive health and rights including massive cuts to Planned Parenthood.
  
  Fewer services also mean more unpaid care work. Employed or not, women are the majority of the nation’s sixty-seven million informal caregivers; they pick up the slack when services disappear. From 1935 to 1970, the services provided by an expanding public sector helped women balance work and family life. Since the mid-1970s, neoliberal budget cuts shifted the costs and responsibility of care work back to women in the home. So does the growing practice of moving the elderly and the disabled from publicly-funded residential centers to home-based care, and discharging hospital patients still in need of medical monitoring and nursing services.
  
  The anti-government strategy also decreased women’s access to the public sector jobs. After World War II, as social movements pressed for an expanded welfare state, these jobs became an important source of upward mobility for white women and people of color excluded from gainful private sector employment. In January 2012, women comprised 57 percent of all government workers.  According to the latest available data, women comprise 43 percent of federal, 51.7 percent of state and 61.4 percent of local government employees. Women filled these jobs because society assigned care work to women, their families needed two earners to make ends meet, and social welfare programs benefited from cheap female labor. The public sector also became the single most important employer for blacks, who are 30% more likely than other workers to hold public sector jobs. More than 14% of all public sector workers are black. In most other sectors, they comprise only 10% of the workforce.
  
  The Great Recession and the slow recovery have decimated public sector employment. During the early stages of the recession, men suffered more than 70% of total job loss because “male” jobs (construction, manufacturing, etc.) are particularly sensitive to cyclical downturns. The current “recovery,” by contrast, has been tougher on women, who comprised over half of the public workforce. From June 2009 to May 2012 as the public sector lost 2.6% of its jobs women suffered 61% of the job losses (348,000 out of 573,000). They gained only 22.5% of 2.5 million net jobs added to the overall economy. In 2012, the poverty rate among women climbed to an astounding 14.5%.
  
  Total union membership plummeted from a peak of 35% of the civilian labor force in 1954 to just 11.3% in 2012 — the lowest percentage of union workers since the Great Depression. Private-sector unionization dropped to 6.6 %. Despite the loss of thousands of government jobs, public unions withstood the onslaught, maintaining an average membership rate of more than 35%. It helped that the majority of public sector work cannot be outsourced or automated.
  
  Seeking to weaken the remaining unions, foes of labor and government turned against the public sector –labor’s last stronghold. Some governors demonized government workers as the new privileged elite to convince the public that collective bargaining rather than tax cuts is the enemy of balanced budgets. When governors strip teachers and nurses of their collective bargaining rights but spare police and firefighters, they hit women especially hard: 61% of unionized women but only 38% of unionized men work in the public sector. The loss of union protection sets women back economically. Unionized women of all races in both public and private jobs earn nearly one-third more per week than non-union women, although white women earn more than women of color. Trade union women face a smaller gender wage gap and are more likely to have employer-provided health insurance and pension plans than their non-union sisters.
  
  Public sector unions historically pressed for high-quality services, dependable benefits, and fair procedures for themselves and for others. In the 1920s, the teacher’s union stood up for greater school funding and smaller class sizes. In the 1960s, unionized social workers fought for fair hearings and due process for welfare recipients. In the 1980s and 1990s, home care workers sought more sustained care for their clients. The loss of union power will cost public sector program users, workers, and union members a strong advocate. Unions remain one of the few institutions with the capacity to represent the middle and working classes and check corporate power inside and outside government.
  
  The attack on the public sector puts women in triple jeopardy. As the majority of public sector program users, workers, and union members, they face fewer services, fewer jobs, and less union protection. In state after state, thousands of government workers and community supporters have raised up against these cuts, unwilling to take the assault on their well being, dignity, and rights lying down. As the National Economic & Social Rights Initiative reminds us, the current agenda amounts to “attacks on public responsibility, the notion of the public good, and the ability of government to secure economic and social rights for all.”  These cuts pose as fundamental threats to the stability and health of both our country’s economy and our democracy.  We must stand together to demand stronger social policies that support women and their families.
  
  This OpEd was adapted from the longer article, “Feminization of Austerity,” New Labor Forum, Winter  21(1) 2012: 32-41.