US citizens are being told they are now captured by corporations because those 5% global banking 1% pols and players have a crony hold on all levels of government doing anything global banking tells them. So, the policy of IPAB today----with this corporate capture means all health care policy and pricing decisions will be made in corporate profit and corporate welfare------with no thought of 99% WE THE PEOPLE and public interest. Our US health system was public and local before Clinton era------our local county PUBLIC HEALTH would have been working for what was best for all Baltimore citizens and all funding from FEDERAL, STATE, AND LOCAL TAXES would reach those health agencies to assure these goals were met. THIS IS HOW IT NEEDS TO WORK AS WE STOP MOVING FORWARD.
We know Obama and Clinton neo-liberals installed the IPAB to make sure global 1% corporations and not 99% of citizens controlled all health policy making sure we could not end PROFITEERING AND CORPORATE WELFARE QUEEN SUBSIDY.
We know that a WORLD HEALTH UNITED NATIONS IPAB would be far worse as global 1% from third world nations having no regard to Western medical ethics and morals would have strong powers of installing policies. We do not want either of these structures to continue to be built.
While 99% of WE THE PEOPLE are watching national news propaganda on sex scandals and FAKE Russian conspiracies ---our local US cities and counties DEEMED FOREIGN ECONOMIC ZONES are MOVING FORWARD these global banking 1% health policies.
Trump is NOT stopping Trans Pacific Trade Pact---he is not stopping IPAB.
04/20/2011 04:32 pm ET Updated Jun 20, 2011
Why Does (Almost) Everyone Hate the IPAB?
By Linda Bergthold
What IS the IPAB you ask?
If you know the answer to this, you will score big points with your friends, because only about .5% of the population knows the answer. The IPAB is the Independent Payment Advisory Board established in the health reform bill to help keep Medicare spending under control. Sounds good, right?
Actually, almost everyone hates the idea of the IPAB. Everyone, that is, except more than 200 economists and health care researchers, the former head of OMB, Peter Orszag, and of course the president of the United States, who made the IPAB a central part of his deficit reduction proposal last week. In fact, he recommended strengthening not repealing it. The reason for the president’s strong support is the conclusion reached by many economists that the type of decisions that need to be made about Medicare spending require independence and expertise.
Here’s what the IPAB is, and why so many groups fear its power. The Board would be composed of 15 members appointed by the president (and subject to Senate confirmation). The members would be physicians, patients, the elderly, economists, health insurers, employers and researchers. This board would be asked to recommend ways to control Medicare spending, triggered by a certain percentage increase in Medicare costs each year. The recommendations of the Board each year must be approved by Congress in their totality unless Congress can come up with options for savings that are similar to what the Board has proposed. Sort of a “base closing” kind of up-or-down vote. There are safeguards for Medicare benefits, however.
With regard to IPAB’s recommendations, the law says:
The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and co-payments), or otherwise restrict benefits or modify eligibility criteria.
There are many reasons why this type of Board faces opposition. Its independence from the political process is both an advantage and a disadvantage. It’s an advantage because recommendations about reducing Medicare costs probably should be done by independent experts (including patients), not by politicians, who can be swayed by financial contributions and pressure from their health care constituencies. It’s a disadvantage for the same reason. The IPAB would be largely independent of congressional control. Politicians do not want to give up the opportunity or responsibility to tweak Medicare, and both Democrats and Republicans oppose the Board for that reason. Many health industry and physician groups also oppose the Board because it could have too much power to reduce or change their rates of reimbursement. Consumer and patient groups have doubts about what the recommendations might do to patient care and coverage (even though the law forbids the Board from reducing benefits). Add to that the difficulty of coming up with recommendations for cuts when you cannot touch benefits or raise revenue, and you get the picture. This is not a popular program.
The arguments against the IPAB are both substantive and ideological. Republicans say that health care recommendations by the IPAB will be made by bureaucrats or “experts” you don’t know (and would be a government takeover of course). Actually that’s the way these decisions are made right now in the way Medicare is administered by private sector plans, and how is that going? Do you know the people in your insurance plan or in the Medicare bureaucracy who are making the decisions about your benefits? They may be bureaucrats, but is it comforting that they are “your” or “Congress’s” bureaucrats? It is true that this Board would not be as accountable to the Congress as it would be to the president, but the IPAB is not completely without accountability given the opportunity for Congress to come up with its own solutions if it doesn’t like what the Board recommends.
As members of the public and current or future patients or Medicare beneficiaries, should we hate the IPAB too? Should we oppose the idea? It all depends on where you think the authority for controlling the cost of Medicare should reside. If you believe that an elected official would make better decisions about Medicare spending, then you would oppose the IPAB. If you think appointed experts from a variety of fields of expertise, then you would support the IPAB. Whatever you believe, there will be plenty of hyperbole launched around this board in the next few months as the federal budget is debated. I personally believe that the IPAB can play an important role in helping to keep Medicare viable, and I think the president has taken a courageous stand in supporting it. Whether it will survive the budget negotiations in the coming months is not clear.
The IPAB was attached to MEDICARE TRUST because for several decades MEDICARE has indeed controlled health costs and been a standard of EQUAL PROTECTION FOR ALL 99% OF WE THE PEOPLE black, white, and brown citizens. Until Clinton era----that was in PUBLIC INTEREST giving the US the strongest and best in quality health care in the world. US citizens went to a local hospital and doctor and felt secure in what was prescribed or procedures done. CLINTON ERA 1990s broke all those protections down, outsourced and privatized to FAKE OLD WORLD MERCHANTS OF VENICE FREEMASON NGOs and private corporate universities all our PUBLIC HEALTH WITH PUBLIC INTEREST.
Fast forward to today-------MEDICARE has been fully privatized, defunded, and these BOARDS are filled with global corporate executives using MEDICARE IPAB to set policies which will take PRIVATE INSURANCE PLANS down as well. So, those middle-affluent class thinking they have that GOLD OR PLATINUM====EVEN THAT LOWLY SILVER PLAN-----will fall under the same constraints set by MEDICARE and IPAB. That means lots of fees and little access to quality health care.
99% WE THE PEOPLE WANT TO RETURN TO MEDICARE LEADING IN PUBLIC INTEREST COST, QUALITY, AND EQUAL ACCESS======SO WE MUST STOP MOVING FORWARD GLOBAL DEREGULATED, PRIVATIZED, PREDATORY, AND PROFIT-DRIVEN AFFORDABLE CARE ACT.
Please do not fall for MEDICARE FOR ALL----SINGLE PAYER----UNIVERSAL CARE as doing this---these are all global banking 1% FAKE talking points.
Global banking 1% pols are using these health reforms aimed at MEDICARE to expand to controlling private health insurance in a very, very NEGATIVE way.
Medicare Leads in Controlling Health Costs
July 21, 2016 at 11:30 AM
Medicare has been the leader in reforming the health care payment system to improve efficiency and has outperformed private health insurance in holding down the growth of health costs, as we note in our newly updated report on Medicare’s finances. Since 1987, Medicare spending per enrollee has grown by 5.7 percent a year, on average, compared with 7.0 percent for private health insurance. (See figure.)
This favorable trend will continue over the coming decade, according to the latest national health expenditure projections from the Centers for Medicare & Medicaid Services (CMS). Medicare spending per enrollee will grow at an annual rate of 3.9 percent between 2014 and 2025, CMS projects, while private health insurance will grow by 4.6 percent.
The Affordable Care Act (ACA) envisions that Medicare will continue to lead the way in efforts to slow health care costs. It authorizes the Center for Medicare & Medicaid Innovation to test new models to reduce program spending while preserving or enhancing the quality of care. And the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 moves toward paying physicians based on quality of care rather than volume of procedures. Along with directly reducing Medicare costs, the ACA and MACRA payment changes may also encourage structural changes throughout the health care payment and delivery system that may generate further savings.
Below we see one reason IPAB installed by OBAMA AND CLINTON NEO-LIBERALS is so bad-------the appointments keep our ELECTED OFFICIALS at Federal, state, and local level in control of health care policy----total control goes to these few people. This is called BIG GOVERNMENT-----global banking 1% is pretending this is SOCIALISM-----government telling 99% WE THE PEOPLE what to do. THIS IS NOT GOVERNMENT----it is a global corporate tribunal ------government is OF THE PEOPLE, FOR THE PEOPLE, BY THE PEOPLE. Don't be confused by terms like BIG GOVERNMENT-----CORPORATE SOCIALISM.
So, yes this is the gorilla-in-the-room issue in health care reform----do you hear any of those FAKE ALT RIGHT ALT LEFT POPULIST pols and 5% players mentioning any of these problems? No, they support AFFORDABLE CARE ACT and just want to TWEEK it----to make it ONE WORLD ONE GOVERNANCE UNITED NATIONS.
'But common sense still matters.
President Obama’s ACA established the Independent Payment Advisory Board (IPAB), a 15-member panel of unelected federal employees; its members to be appointed by the president and confirmed by the Senate. The law does not require the IPAB to be bi-partisan in structure, as is required for almost all other independent agencies. Its mission is specific - to restrict payments to doctors and hospitals in order to achieve a reduction in Medicare spending beneath a specified cap'.
The GORILLA-IN-THE-ROOM issue bigger than IPAB with no bi-partisan rules-----CLINTON/BUSH/OBAMA are of course ONE WORLD ONE POLITICAL PARTY------is this FAST-TRACK cuts to MEDICARE.
US citizens constantly here of this term FAST-TRACKING----it is a policy installed these few decades ago----rarely used decades ago-----now used all the time. It takes all deliberation and participation out of Congress, state assemblies, and local government and makes excuses of EMERGENCY NEED OF EFFICIENCY in installing policy from a BOARD like IPAB----right away. No time for 99% of WE THE PEOPLE to know what is happening or to respond to stop MOVING FORWARD.
Again, Wyden of OR is pretending to push this as he is a raging global banking 1% ONE WORLD UNITED NATIONS 5% pol. He pretends because OR tends to be right wing conservative more so than CA and WA.
As far-right wing global banking 1% ----CLINTON/OBAMA love that FAST-TRACKING as much as BUSH NEO-CONS. Anything to take 99% OF WE THE PEOPLE out of legislative process.
Wyden Pushes to Block Fast-Track Cuts to Medicare
Resolution and Bill Blocking IPAB Would Prevent Administration from Rushing Through Harmful Policies to Undermine Medicare
WASHINGTON – Senate Finance Committee Ranking Member Ron Wyden, D-Ore., today introduced a resolution and a bill that would prevent the Independent Payment Advisory Board (IPAB) process from moving forward. The resolution comes before the Feb. 1 statutory deadline required to discontinue the process.
“Given the Trump administration’s short but disturbing record of irresponsible and cruel executive actions, it would be a huge mistake to leave in place the authority to push through harmful cuts to Medicare with minimal input from Congress,” Wyden said. “The president has picked people to lead his health care team at HHS, including Congressman Tom Price, who have long records of supporting policies that would shift cost to seniors and other vulnerable Americans. I am deeply concerned about their commitment to the promise of Medicare – a promise of guaranteed health benefits for seniors and vulnerable Americans who count on it.”
Independent Payment Advisory Board, commonly referred to as IPAB, was set up under the Affordable Care Act to make recommendations to reduce Medicare spending if it exceeds a certain target. The ACA allows for a one-time, fast-track process to discontinue the entire IPAB process, but it requires that a joint resolution be introduced no later than February 1, 2017.
Wyden introduced both a resolution, as prescribed by statute, as well as a bill to unwind IPAB. The resolution takes advantage of a one-time opportunity to discontinue the process, whereas the bill repeals IPAB in full.
We have shouted for over a decade that MARYLAND was ground zero for all this global banking 1% global corporate health reform policy----so, it makes sense our Maryland Assembly working for global HEDGE FUND IVY LEAGUE JOHNS HOPKINS would MANDATE health insurance coverage under one of the most privatized and unjust state corporate health systems in the nation.
The MANDATE-----tied to a global corporate IPAB making policy and pricing ASSURES that 99% of Maryland and US citizens will be SOAKED with fees in insurance policy monthly payments while not getting the access to ordinary care. WE THE PEOPLE will be declared TOTALED===as our auto insurance had been allowed to do these few decades and declared not worth the investment in REPAIRS.
More and more American citizens and Maryland citizens are being pushed to CATASTROPHIC health plans just because of these GOALS.
THIS HEALTH MANDATE TIED TO WORLD HEALTH IPAB------ASSURES US CITIZENS AND OUR IMMIGRANT LABOR POOL 99% WILL BE VICTIMS -----
All of our Maryland candidates for GOVERNOR---no matter if running as REPUBLICAN OR DEMOCRAT are pledged to MOVE FORWARD all these global banking 1% health reforms ---killing our US best in world history AMERICAN PUBLIC HEALTH CARE.
IT HAS ABSOLUTELY NOTHING TO DO WITH FUNDING HEALTH CARE FOR THE POOR=======
General Assembly weighs bill to require Marylanders to buy health insurance
Andrea K. McDanielsContact Reporter Baltimore Sun
Responding to the federal repeal of the individual mandate requiring everyone to have health insurance, Maryland lawmakers are considering legislation that would impose the requirement at the state level.
“We need to find some way to stabilize the individual insurance market. The premium increases we are facing are really high if we don’t,” said Sen. Brian J. Feldman, a Montgomery County Democrat and sponsor of the bill.
The federal requirement was a key part of the Affordable Care Act designed to ensure enough people were on the insurance rolls to keep costs down. Congress removed the mandate as part of the federal tax overhaul passed in December.
“I think there is a strong desire to respond to what is happening on Capitol Hill,” Feldman said.
The proposal will get hearings this week.
The legislation has the support of more than half of the House of Delegates. Sen. Thomas M. “Mac” Middleton, a Charles County Democrat who co-sponsored the Senate bill, chairs the committee that will consider the legislation in that chamber. He calls the proposal “innovative.”
Maryland is one of about nine states currently weighing legislation to replace the federal mandate with a state one, but with a unique twist.
The Maryland bill would require those who choose not to buy a plan to pay an annual fine starting at $700, but it would offer people the option of using that money as a down payment to purchase insurance the following year. Supporters hope to use the fine to prod people to get coverage rather than penalize them.
With federal subsidies and incentives, 60,000 of the state’s 200,000 uninsured could buy insurance for less than or the same cost as the proposed fine, supporters say.
Getting more people to buy health insurance could help slow the skyrocketing premium increases faced by people who buy their health coverage on the state insurance exchange.
WHAT DO STATS ALREADY SHOW? HAVING HEALTH INSURANCE DOES NOT MEAN ACCESSING HEALTH CARE---WHICH IS THE GOAL.
“We in Maryland need to make sure people are insured to keep their premiums down,” said Del. Joseline Pena-Melnyk, a Montgomery County Democrat sponsoring the bill. “We think this will allow us to keep health care accessible and affordable.”
The insurance mandate — one of the most reviled aspects of the law known as Obamacare — is considered essential to its success. When mostly sick people enroll for insurance it drives prices up.
“The Republicans did some real damage to the ACA by repealing the individual mandate,” said Jonathan P. Weiner, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health. “The ranks of the U.S. uninsured could increase by 13 million over the next decade because of this. The Maryland legislature is the leader of a pack of eight or so blue states trying to respond to this federal repeal by enacting a similar mandate at the state level.”
The idea of using the penalty as an incentive for people to buy insurance is a new one, Weiner said.
MARYLAND IS A GLOBAL BANKING 1% OLD WORLD MERCHANTS OF VENICE ROYAL STATE---NOT DEMOCRATIC OR BLUE.
“What the Maryland legislature is proposing is both timely and innovative,” Weiner said. “Not only does it replace what the Republicans took away, it improves upon the soon-to-be-defunct federal law by seamlessly converting tax penalties into insurance coverage, rather than simply depositing it into the state’s coffers.”
Lawmakers propose automatically putting people’s fines toward purchasing insurance unless they opt out. They would send out a form to those who were uninsured the previous year and tell them that unless they say otherwise it would put the fine toward a health plan for the following year in the form of a down payment. Uninsured individuals would have to check a box to pay the fine instead.
For those who choose not to opt out, the legislation would put their penalty in escrow until the next enrollment period to use for an insurance plan. People also would be notified by the state during open enrollment time and provided with information about how to apply the $700 toward insurance and other insurance options available.
“We believe that this is a way to really encourage these folks who haven’t signed up to do so,” said Stan Dorn, a senior fellow at Families USA who helped develop the plan. “They will have to make the choice of using the money to pay for insurance or have it go to state coffers.”
FAMILIES USA IS A FAR-RIGHT WING GLOBAL BANKING 1% ALT RIGHT ALT LEFT GROUP=====NOT A REAL LEFT SOCIAL PROGRESSIVE GROUP.
Gov. Larry Hogan has not said if he will support the bill but has called the individual mandate “basically a tax.” He has said he is in favor of “incentives” that could help reduce the cost of health care.
Hogan’s spokesman, Doug Mayer, sent YouTube video clips from a January news conference when asked about the governor’s position on an individual mandate. In one video, Hogan announced he would work with leaders of the House and Senate to stabilize the insurance market under the Affordable Care Act. He called the stakes tremendous, noting that thousands of people could lose their insurance and the market could collapse if no solution is found.
HOGAN IS FAR-RIGHT GLOBAL BANKING 1% AS A REPUBLICAN SO YES, HE WILL SUPPORT A CLINTON NEO-LIBERAL HEALTH POLICY.
“These issues are much too important and the impact too far-reaching for us to get it wrong,” Hogan said.
Mayer said Hogan has been meeting with both delegates and senators to come up with solutions and that the meetings have been productive.
Representatives for House Speaker Michael E. Busch and Senate President Thomas V. Mike Miller said the two lawmakers also were working with people from the medical and insurance industries as well as other legislators on solutions to stabilize the market, but were not yet ready to comment on specific legislation.
There are a dozen or so bills pending in the General Assembly to address the issue. The bills cover a wide range of ways to stabilize the market, including creating a high risk pool and merging the small business and individual markets.
Vincent DeMarco, president of Maryland Citizens' Health Initiative, praised the idea of using the penalty to help pay for insurance. His group is pushing the bill.
“We think that once people know, they will opt for the insurance,” he said.
MARYLAND HEALTH CARE FOR ALL AND MARYLAND CITIZENS' HEALTH INITIATIVE ARE BOTH GLOBAL HEDGE FUND IVY LEAGUE JOHNS HOPKINS FAKE 'LABOR AND JUSTICE' ORGANIZATIONS.
'The American Enterprise Institute has pointed out, that IPAB “emphasizes payment reductions at the expense of real Medicare reform'.
Here is the FAKE RIGHT WING global banking 1% Bush neo-cons pretending they are protecting right wing voters from what is a far-right wing health policy goal. As we said----IPAB will be made UNITED NATIONS WORLD HEALTH IPAB via TRANS PACIFIC TRADE PACT------TPP---which all Congressional Republicans support and those same right wing Republicans are the source of FAST-TRACKING POLICY installed a few decades ago.
What we see Republicans doing in fighting to repeal Affordable Care Act is repealing all that does not fit with MOVING FORWARD TRANS PACIFIC TRADE PACT----which includes public trusts and subsidies for health care for seniors, disabled, and poor. CLINTON/OBAMA doing just the same.
The right wing coining the term DEATH PANELS tied to OBAMA and Clinton neo-liberal health care reform has nothing to do with their own goals doing the same----it is simply a TALKING POINT to the right wing voters----and yes, the IPAB will be illegally denying US citizens access to health care that will cause them to die prematurely.
House Votes To Abolish Obamacare Board That Conservatives Called A ‘Death Panel’
7:50 AM 11/03/2017
WASHINGTON — The House Thursday voted to repeal a key government board established by the Affordable Care Act that conservatives rallied against during the Obamacare debate seven years ago out of concern that the provision could wind up rationing medical care for patients.
The Independent Payment Advisory Board (IPAB), famously called a “death panel” by its opponents, is a 15-member federal agency intended to reduce Medicare without taking away coverage or quality of care. The American Enterprise Institute has pointed out, that IPAB “emphasizes payment reductions at the expense of real Medicare reform. The constraints placed on what the IPAB can recommend were not accidental. The authors of the ACA support restraining Medicare spending, but only with government-imposed payment restrictions, not financial incentives.”
The IPAB can make recommendations about cuts to Medicare sans congressional oversight or input. IPAB proposals use “fast track” protocols and require a three-fifths vote in the Senate for Congress to alter the kinds of cuts to Medicare. Even then, Congress may not change the amount of cuts made. If Congress does not act on the board’s recommendations, they automatically go into effect. Additionally, the IPAB is immune to judicial or administrative review.
Tennessee Republican Rep. Phil Roe introduced two pieces of legislation back in February, to repeal the IPAB. The first, H.J. Res. 51, would enable the Senate to utilize a “fast track” parliamentary mechanism to repeal the IPAB. The second, H.R. 849, is the same bill Roe proposed in the prior Congresses to repeal the board.
Members voted 307-111 to do away with the Board, but the future of the legislation in the Senate is still on shaky ground as it is a stand-alone bill and would need 60 votes to end debate before a final simple majority passage vote. According to The Hill, no appointees are on IPAB presently and budget experts predict that IPAB won’t be triggered until 2021 or 2022.
Here we see UK having installed these same FAST-TRACKING health policies. Below we see how US PHARMA and MEDICAL DEVICES have hit the FAST TRACK at a time when tens of millions of citizens are harmed and/or killed by these untested products.
Obama and Clinton neo-liberals LOVE FAST-TRACKING------because it gives the 99% of WE THE PEOPLE no time to organize against policies flying out of CLOSED CORPORATE BOARDS.
So, like TRANS PACIFIC TRADE PACT----TPP------the Affordable Care Act pushed fast-tracking ability on this IPAB and RIGHT WING REPUBLICANS love this---it is a FAR-RIGHT WING HEALTH POLICY after all.
'Fast Track - Food and Drug Administration
/Fast/ucm405399.htm Jan 03, 2018 · Fast track is a process designed to facilitate the development, and expedite the review of drugs to treat serious conditions and fill an unmet medical need'.
EPHA Briefing |
Will fast-tracking medicines improve affordability?
by Yannis Natsis | May 30, 2016 | Universal Access and Affordable Medicines | Strategic Documents, Universal Access and Affordable Medicines Campaign
These fast-track policies created by an IPAB whether national or ONE WORLD UNITED NATIONS WORLD HEALTH----are designed to be installed EVERY YEAR----so health policy would look different every time a citizen needed to access care.
Continuing Care Fast Track assessments – how to get a quick decision
Care to be Different > Articles > NHS Continuing Healthcare >
Continuing Care Fast Track assessments – how to get a quick decision
Posted on July 16, 2012 in NHS Continuing Healthcare
Many families are wrongly told that NHS Continuing Healthcare funding is only available for people who are at the end of their life. Not only is this incorrect, it often means that elderly people with significant health needs are wrongly denied the free NHS care they are entitled to in law.
Continuing Healthcare funding for care fees depends on the extent of your relative’s health needs, not what stage of your life they’re at. Assessments are supposed to be carried out swiftly, no matter what your relative’s degree of health needs. There is, however, a special process that should be used in emergency situations when a person is in a period of rapid deterioration or when a person is in ‘terminal decline’ at the end of their life.
National Framework guidelines, page 32, paragraph 97:
“Individuals with a rapidly deteriorating condition that may be entering a terminal phase, may require ‘fast tracking’ for immediate provision of NHS continuing healthcare.”
Nursing care is provided by the NHS, and NHS care is free – in law. The Continuing Healthcare eligibility criteria are based purely on care needs and NOT on a person’s money, and by looking at the criteria – and at the local authority legal limit for means tested care – it will be clear whether or not a person should receive full NHS funding for their care.
If your relative is in terminal decline at the end of their life or in a period of rapid deterioration, you can insist on them having an urgent Continuing Healthcare assessment. This is done using the NHS Continuing Healthcare Fast Track process (‘Fast Track Pathway Tool for NHS Continuing Healthcare’). Essentially, it’s a fast assessment to get NHS funding in place as quickly as possible.
Here are some of the key points to keep in mind about this NHS Continuing Healthcare Fast Track process:
- It is used if your relative has urgent health needs and/or nursing needs and is rapidly deteriorating and/or in a terminal phase of life. It is also used if your relative’s health is likely to deteriorate rapidly before the next routine Continuing Healthcare review. It is not only for people at end of life.
- It allows a quick decision to be made about Continuing Healthcare funding. As part of this, it allows appropriate end of life support to be put in place quickly by the NHS – free of charge – and it means your relative can have care provided in their preferred location, including at home.
- The Fast Track assessment should be carried out by a registered medical practitioner (the ‘assessor’), such as a GP, consultant, registered nurse, hospice clinician, etc – but this person must have detailed knowledge of your relative’s needs. Unfortunately, families report that GPs and other medics often have little (if any) knowledge of the Continuing Healthcare assessment process, and it can fall to the family to ‘educate’ them in this respect. This can be immensely frustrating for the family at a time when urgent action is required.
- In the Fast Track assessment the assessor makes the decision that person is in a rapidly deteriorating state and/or in a terminal phase and with an increasing level of dependency. This decision should be accepted and acted upon immediately by the NHS.
- There should be no delay in providing free NHS Continuing Healthcare funding just because NHS or local authority staff are arguing or debating how the Fast Track should be used.
- Your relative should be moved to his/her preferred place of care and have funding immediately put in place without having to go through the long-drawn-out ‘full’ multidisciplinary team Continuing Healthcare assessment process. The NHS is responsible for this. If your relative is already in a care home, and no longer owns their own home, it may be that the care home will be the best place in which to remain.
- Once Fast Track Continuing Healthcare funding is in place, it should never removed without the NHS going through the proper review process, i.e. a full assessment process carried out by a multi-disciplinary team (MDT). This ‘full’ assessment process uses a form called the ‘Decision Support Tool’ (DST). Only once the Fast Track assessment is complete and funding is put in place should an MDT review process ever be started – and only if this MDT assessment is really necessary. This full MDT assessment process should never delay urgent Fast Track end-of-life funding and care.
- If parts of the Fast Track form have not been completed, or if the assessor does not know how to complete it, or the patient cannot assist in completing it, this should never delay a decision about funding or delay NHS care being put in place.
Remember, ask for a Fast Track assessment if you feel your relative should have one. If this is declined, and yet it’s clear that your relative is declining rapidly, put your concerns in writing to the Chief Executive of your relative’s local NHS (Clinical Commissioning Group) and copy it to the Continuing Healthcare Team, the GP, all appropriate consultants, nurses, medics, clinicians, carers and the care home manager (if relevant).
If necessary write to your MP.
If it’s obvious that your relative needs urgent nursing care, you could also refuse to pay (or continue to pay) care fees at this point.
This does, of course, raise a further question: If a rapid decision can be made using the Fast Track process, why can’t all NHS Continuing Healthcare assessments be as quick?
GLOBAL BANKING 1% ARE ONLY TRYING TO HELP 99% US WE THE PEOPLE
'This, it continues, contradicts the principles of the Commission’s ‘Better Regulation’ agenda. “We are seriously worried about the precedent that such rushed, unscientific and inconsistent proposals would set.”'
FAST TRACKING is now taking all US, UK, and slowly European public policy especially around HEALTH CARE REFORM. Does a patient told they have no other access want to try experimental medicine? We have always had that choice. Using the term FAST-TRACKING in medicine is not about patients gaining RIGHTS-----it is about by-passing all our 20th century regulations and processes in place to protect 99% of WE THE PEOPLE from harm and death.
Below we see CHEMICAL CORPORATIONS are having their guidelines for protecting public health weakened through FAST TRACKING sending chemicals out into the public once banned as harmful----or killing the research and development clinical trials needed to assess harm.
IF WE ARE ENDING PUBLIC PROTECTION AND ACCESS TO MEDICAL TREATMENT FROM DEVASTATING TOXIC INDUSTRIAL EXPOSURES WE MAY AS WELL FAST-TRACK THE NEED TO RESEARCH WHETHER THOSE CHEMICALS CAUSE HARM.
'However, chemicals and policy officer at NGO ChemSec, Jerker Ligthart, told Chemical Watch that using the fast-track approach is the “right way to go”, due to its focus on consumer protection and the well-known hazardous properties of these classified substances'.
When we have a HEALTH INSURANCE MANDATE----tied to an IPAB making decisions on patient care with the power of telling a patient they HAVE TO USE THIS PRODUCT as it is efficient-----we are open to global medical corporations doing ANYTHING THEY WANT under the guise of providing HEALTH CARE ACCESS.
Global corporate factories are REAL KILLERS.
Fast tracking CMR restrictions sets ‘dangerous precedent’
Textile trade groups ‘deeply concerned’ by plans for 286 substances
30 March 2016 / Children's products, Europe, Priority substances, Textiles & apparel
A group of trade organisations is calling for the European Commission to abandon its proposal to “fast track” the restriction of 286 carcinogenic, mutagenic, reprotoxic (CMR) substances in textiles consumer articles.
Responding to the Commission’s consultation on the proposal, the group of textiles and wider industry associations, which includes Euratex, the Foreign Trade Association, EuroCommerce and the American Chamber of Commerce for the EU, raise a number of concerns in a joint statement.
Among these, it says the use of Article 68 (2) – which sets out the fast-track procedure under REACH – would ignore the importance of the “evidence-based usual restriction process under REACH”.
The fast-track approach, it says, is not appropriate for such a large number of substances, sets a dangerous precedent for bad regulation and could also impact the European economy negatively.
The group says it is “under the impression” that the potential impact of the proposed restriction has not been assessed adequately and that “political motivations are driving the overly ambitious procedure”.
It questions the "appropriateness" of addressing a list of 286 substances in the two-three months, allocated by the Commission.
“Considering the substantial amount of time, work and resources spent in the exercise of responding to the consultation, it is arguable whether the European Commission is willing to support European SMEs, and design EU policies and laws that achieve their objectives at minimum cost and informed by the best available evidence,” it adds.
This, it continues, contradicts the principles of the Commission’s ‘Better Regulation’ agenda. “We are seriously worried about the precedent that such rushed, unscientific and inconsistent proposals would set.”
However, chemicals and policy officer at NGO ChemSec, Jerker Ligthart, told Chemical Watch that using the fast-track approach is the “right way to go”, due to its focus on consumer protection and the well-known hazardous properties of these classified substances.
“It is widely agreed that known and classified CMR substances do not have a place in consumer articles, especially in the consumer textiles product group as it is worn directly on the skin,” he added.
Last month, ChemSec said the proposal should be expanded to cover all CMRs used in the industry, not just category 1A and 1B classified substances.
Consumer groups have even called for the proposed restriction to go beyond just CMRs. European Consumer Organisations, Beuc and Anec, say persistent, bioaccumulative, toxic (PBT) very persistent, very bioaccumulative (vPvB), (neuro)toxic, endocrine disruptors and substances with probable serious effects to human health, such as sensitisers or irritants, should also be included.
They also recommend establishing a separate, product-specific regulation for textiles, which would allow it to address all substances of concern in an “appropriate way”.
In a separate response, textiles trade body, Euratex, proposes that an ad-hoc industry scientific committee is established to support decision making.
This committee, it says, would include a representative panel of industry-appointed experts to discuss with the Commission and advise on the feasibility of restriction, valid replacement options and the impact of decisions.
The Commission says it is collating responses and will evaluate them in "due course".
We will end discussion over FAST TRACKING, IPAB as a national vs WORLD HEALTH UNITED NATIONS policy tied to US MEDICARE and by extension all aspects of US public health by revisiting the history behind US CONGRESSIONAL ability to FAST TRACK.
We always shout that FDR creating the status of US FOREIGN ECONOMIC ZONES were restricted to DUTY/TAXES tied to import export. Back then of course our US economy was mostly domestic so these policies were background in our economy. It was NIXON-ERA with all that OPENING UP CHINA making global markets take the majority of our US economy and FAST TRACK policies BROADENED from only duty/taxes to all aspects of FOREIGN POLICY tied to trade-----ergo, it is undermining every aspect of our economic and societal structures determined by 300 years of US CONSTITUTIONAL RIGHTS, 3 BRANCHES OF GOVERNMENT CHECKS AND BALANCES----and of course any thought that 99% of WE THE PEOPLE would be involved in public policy.
So, 1970s expanded the use of FAST TRACK and 1990s super-sized that expansion. This is why we have CONGRESS trying to fast track TRANS PACIFIC TRADE PACT----totally killing 300 years of US governance structures.
'Today, the fast track approach of the 1970s is under stress'.
When we speak of HEALTH CARE POLICY we are MOVING FORWARD issues of LIFE AND DEATH-----issues of global boards installing policies actually having a goal of HARM over GOOD.
WE ARE ALREADY SEEING THIS PREDATORY MEDICINE IN US THESE FEW DECADES NOW GROWING IN AFFORDABLE CARE ACT----IPAB-----We simply need to reverse these expansions as they create illegal MONOPOLY-----they create an illegal circumvention of our US Constitutional rights AS CITIZENS TO LEGISLATE.
Simply REPEAL IT ---VOID IT as illegal ---easy peasy.
Rethinking the Roles of Congress and the President in "Fast Tracking" U.S. Trade Negotiations
Charles Hankla, Georgia State University
In January 2014, President Obama formally requested that Congress grant him Trade Promotion Authority – also known as “fast track” – to speed the negotiation of two treaties that could transform America’s relationship with international markets. The pending Transpacific Partnership would eliminate key trade barriers between the United States and eleven Asian countries, including Japan. Of even greater potential significance, the Transatlantic Trade and Investment Partnership would merge the world’s two largest markets, the United States and the European Union, into a single interdependent commercial zone.
If fast track authority were granted, Congress would have to vote on agreements negotiated by the President within ninety days, up or down with no amendments. But opposition erupted right after President Obama made his request. Many in Congress are no longer willing to grant presidents such latitude on trade agreements that impact jobs and worker rights, the environment, and a host of other societal concerns. The current impasse puts in stark relief the challenges faced by the United States government as it seeks to develop a coherent approach to increasingly globalized commerce. Presidential authority is more important than ever, but Congress is no longer willing to step back. New arrangements are needed.
The Origins and Limits of Fast Track
In the eighteenth century, trade policy was considered a source of revenue rather than an instrument of foreign policy, so the U.S. Constitution granted nearly complete authority to Congress. Congress remained in charge for more than a century, setting U.S. tariff levels by direct votes as on any other legislation. Difficulties came to a head with the infamous Smoot-Hawley Tariff of 1930, when a series of Congressional logrolls raised U.S. tariffs to extraordinary levels that sparked retaliation from Europe and, as most scholars agree, helped worsen the Great Depression.
In 1934, Congress granted greater authority to the executive branch in the Reciprocal Trade Agreements Act, for two main reasons:
- To limit interest group pressures that could drive tariffs to dangerous levels. Even if each member of Congress advocated for the protection of only one commodity made in his or her district, the logrolling process could add up to harmful overall outcomes. The President, hopefully, could better represent the national interest as a whole.
- To enable the President, as the agent of U.S. foreign policy, to use trade concessions as leverage to generate reciprocal concessions from trading partners.
By that point, international trade negotiations had moved beyond tariffs into more complex areas where pre-set limits were no longer feasible. In place of the older system, the Trade Act of 1974 created fast track authority, where Congress provides very general guidance on trade policy goals and rules for consultation, and agrees to put any agreement signed by the President to a prompt up or down vote. Overall, this delegates more authority to the executive branch to handle complex, contingent negotiations – yet it also limits the President’s authority to make adjustments after he signs an agreement and sends it to Congress.
The Need for Revisions in Fast Track Authority
Today, the fast track approach of the 1970s is under stress. Newly pressing issues such as intellectual property rights, environmental, health, and labor regulation, and domestic subsidies make it impossible for senators and representatives to remain uninvolved as negotiations proceed. An even stronger role for the executive branch is justified by its technical expertise, facility with secret international negotiation, and ability to speak for the United States as a whole. Yet how can representatives and senators remain uninvolved in discussions of politically salient matters such as labor rights and food safety, or ignore matters of national security that get drawn into trade negotiations (as with the extension of free trade to drug-violence-plagued Colombia or the exclusion of China from the Transpacific Partnership)?
Because it is highly unlikely that Congress will accept anything less than a more complete partnership, here are some ways the fast track approach could be revised and updated:
- Congress could narrow the authority it grants the President by specifying the countries, broad issues, and agreements to which fast track applies, rather than granting this authority for a fixed period of time. Specific guidelines could actually boost U.S. bargaining power, as research has shown that a strong legislature with veto power can toughen a country’s negotiating stance.
- Congress could demand more regular consultation according to specific procedures. Given the fluidity of international negotiations, a small number of Congressional members would have to be authorized to meet regularly with negotiators.
- Congress could insist on more public access to information during ongoing negotiations.
- Congress could extend the 90 day voting period and enable amendments supported by supermajorities. Or it could require that Congress approve a draft trade agreement before the President signs it, enabling the revision of points that Congress finds objectionable.
- Congress can insist on legislation to more fully guide implementation after a pact is approved.